Individual provider Active NPI

Gary R Skelton Jr., RN

  • Registered Nurse
  • San Antonio, TX
National Provider Identifier
1427776004
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1087296 Issued in TX
Practice address
4949 Gus Eckert Rd
San Antonio, TX 78240-4471
Phone
(210) 690-0360
NPI assigned
Aug 18, 2022
Last updated
Aug 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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 1087296 TX Primary

Addresses

Primary practice location

4949 Gus Eckert Rd
San Antonio, TX 78240-4471

Mailing address

11734 Poppy Sands
San Antonio, TX 78245-3221
Phone (254) 423-3388

Other practice location 1

11734 Poppy Sands
San Antonio, TX 78245-3221
Phone (254) 423-3388

Other practice location 2

9504 N Ih 35 Ste 310
San Antonio, TX 78233-6617
Phone (254) 423-3388

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
1087296TXMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1427776004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11734 POPPY SANDS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782453221",
            "telephone_number": "254-423-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 GUS ECKERT RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404471",
            "telephone_number": "210-690-0360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11734 Poppy Sands",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782453221",
            "country_code": "US",
            "telephone_number": "254-423-3388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9504 N Ih 35 Ste 310",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782336617",
            "country_code": "US",
            "telephone_number": "254-423-3388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "1087296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.