Individual provider Active NPI

Pamela Ann Skocic, RN

  • Registered Nurse
  • Berea, OH
National Provider Identifier
1386096824
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.400409 Issued in OH
Practice address
434 Eastland Rd
Berea, OH 44017-1217
Phone
(440) 260-8327
Fax
(440) 260-8305
NPI assigned
Jul 8, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.400409 OH Primary

Addresses

Primary practice location

434 Eastland Rd
Berea, OH 44017-1217

Mailing address

434 Eastland Rd
Berea, OH 44017-1217
Phone (440) 260-8327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN.400409OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1386096824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-260-8327",
            "fax_number": "440-260-8305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 EASTLAND RD",
            "city": "BEREA",
            "state": "OH",
            "postal_code": "440171217",
            "telephone_number": "440-260-8327",
            "fax_number": "440-260-8305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCIC",
        "first_name": "PAMELA",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-08",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.400409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berea, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.