Individual provider Active NPI

Linda Skolnick, PSYD

  • Clinical Psychologist
  • Springfield, MO
National Provider Identifier
1447256029
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2001024798 Issued in MO
Practice address
1300 Bradford Parkway
Springfield, MO 65810
Phone
(417) 761-5000
NPI assigned
Jun 28, 2005
Last updated
Feb 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2001024798 MO Primary

Addresses

Primary practice location

1300 Bradford Parkway
Springfield, MO 65810

Mailing address

1300 Bradford Parkway
Springfield, MO 65810
Phone (417) 761-5000

Other identifiers 1

IdentifierTypeStateIssuer
495733602MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205001030 MO Practitioner - Clinical Psychologist 1456676824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2001024798MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Magers Family Health and Wellness Center CurrentSince Jan 15, 2015 Accepting new patients

Locations

901 S National Ave
Springfield, MO 65897
Phone (417) 836-4000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328486400000",
    "number": "1447256029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 BRADFORD PARKWAY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65810",
            "telephone_number": "417-761-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 BRADFORD PARKWAY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "65810",
            "telephone_number": "417-761-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOLNICK",
        "first_name": "LINDA",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2012-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2001024798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495733602",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.