NPIMap

Individual provider Active NPI

Brandon W Skelton, M.D.

  • Diagnostic Radiology Physician
  • Corinth, MS
National Provider Identifier
1346460367
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101240781 Issued in VA
Practice address
611 Alcorn Dr
Corinth, MS 38834-9321
Phone
(662) 821-1837
Fax
(662) 680-5103
NPI assigned
May 1, 2007
Last updated
Jul 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 46706 TN
Diagnostic Radiology Physician 2085R0202X 21303 MS
Student in an Organized Health Care Education/Training Program 390200000X 0116018271 VA
Diagnostic Radiology Physician 2085R0202X 0101240781 VA Primary

Addresses

Primary practice location

611 Alcorn Dr
Corinth, MS 38834-9321

Mailing address

PO Box 2285
Corinth, MS 38835-2285
Phone (662) 507-2444

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bskelton@mrhc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110503000692 MS Practitioner - Diagnostic Radiology 0840324976 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tippah County HospitalGroup PAC ID 5193746709, shared by 6 NPIs, 24 clinicians
Magnolia Imaging Associates, PLLCGroup PAC ID 2264660026, 4 clinicians
Magnolia Regional Health CenterGroup PAC ID 9739078460, 15 clinicians

Practice addresses (Care Compare)

1005 -A City Ave N
Ripley, MS 38663-1414
Phone (662) 837-9221

611 Alcorn Dr
Corinth, MS 38834-9321
Phone (662) 286-0090

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46706TNMDDiagnostic Radiology Physician
0101240781VAMDDiagnostic Radiology Physician
0116018271VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Tippah County Hospital CurrentSince Oct 18, 2010 Accepting new patients
Tippah County Hospital Current Accepting new patients
Tippah County Hospital CurrentSince Oct 18, 2010 Accepting new patients
Tippah County Hospital Diagnostic Radiology CurrentSince Oct 1, 2023 Accepting new patients
University of Virginia Physicians Group PastSince Nov 1, 2017 Accepting new patients

Locations

1005 City Ave N
Ripley, MS 38663
Phone (601) 837-9221

1005 City Ave N
#A
Ripley, MS 38663
Phone (662) 837-2202

Interoperability endpoints

  • Direct secure messaging: bskelton@mrhc.org
  • FHIR API: https://fhir-usa.unify.chbase.com/org/tippah-ba3c06de

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1346460367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2285",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388352285",
            "telephone_number": "662-507-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349321",
            "telephone_number": "662-821-1837",
            "fax_number": "662-680-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "BRANDON",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "46706",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "21303",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116018271",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101240781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bskelton@mrhc.org",
            "affiliation": "N",
            "endpointDescription": "Direct Messaging Addres",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "611 Alcorn Dr",
            "city": "Corinth",
            "state": "MS",
            "country_code": "US",
            "postal_code": "388349321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corinth, MS

Sources for this page

Verify at the official NPI Registry.