Active NPI
Martin Skokan
- Physical Therapist
- Mount Morris, MI
National Provider Identifier
1457768798
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501014106
- Practice address
- 7057 N Clio Rd
Mount Morris, MI 48458-8261 - Phone
- (888) 218-4045
- Fax
- (810) 249-4230
- NPI assigned
- Jul 18, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501014106 | MI | Primary |
Addresses
Primary practice location
7057 N Clio Rd
Mount Morris, MI 48458-8261
Mailing address
3495 S Center Rd
Burton, MI 48519-1455
Phone (810) 424-2011
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457768798 | Medicaid | MI |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1457768798",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3495 S CENTER RD",
"city": "BURTON",
"state": "MI",
"postal_code": "485191455",
"telephone_number": "810-424-2011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7057 N CLIO RD",
"city": "MOUNT MORRIS",
"state": "MI",
"postal_code": "484588261",
"telephone_number": "888-218-4045",
"fax_number": "810-249-4230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOKAN",
"first_name": "MARTIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-18",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501014106",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457768798",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mount Morris, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.