Individual provider Active NPI

Ralph D Skowron, M.D.

  • Emergency Medicine Physician
  • Friendship, WI
National Provider Identifier
1437214780
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
32915 Issued in WI
Practice address
402 West Lake St.
Moundview Memorial Hospital
Friendship, WI 53934
Phone
(608) 339-8357
Fax
(608) 339-8359
NPI assigned
Dec 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 32915 WI Primary

Addresses

Primary practice location

402 West Lake St.
Moundview Memorial Hospital
Friendship, WI 53934

Mailing address

N2331 Greenville Dr
Hortonville, WI 54944-8714
Phone (920) 779-9840

Other identifiers 1

IdentifierTypeStateIssuer
31788900MedicaidWI

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1437214780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N2331 GREENVILLE DR",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549448714",
            "telephone_number": "920-779-9840",
            "fax_number": "920-779-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 WEST LAKE ST.",
            "address_2": "MOUNDVIEW MEMORIAL HOSPITAL",
            "city": "FRIENDSHIP",
            "state": "WI",
            "postal_code": "53934",
            "telephone_number": "608-339-8357",
            "fax_number": "608-339-8359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOWRON",
        "first_name": "RALPH",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "32915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31788900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendship, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.