Individual provider Active NPI

Susan Skoczynski

  • Medical-Surgical Registered Nurse
  • Muskego, WI
National Provider Identifier
1538750898
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
117315-30 Issued in WI
Practice address
S76W15425 Woods Rd
Muskego, WI 53150-8612
Phone
(414) 852-2058
NPI assigned
Jan 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 117315-30 WI Primary

Addresses

Primary practice location

S76W15425 Woods Rd
Muskego, WI 53150-8612

Mailing address

S76W15425 Woods Rd
Muskego, WI 53150-8612
Phone (414) 852-2058

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Muskego Direct

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

State licenses

LicenseStateTypeSpecialty
117315-30WIMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1611878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1538750898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S76W15425 WOODS RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508612",
            "telephone_number": "414-852-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "S76W15425 WOODS RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508612",
            "telephone_number": "414-852-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOCZYNSKI",
        "first_name": "SUSAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-29",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "WI",
            "license": "117315-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Muskego",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Muskego",
            "address_1": "S76W15425 Woods Rd",
            "city": "Muskego",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531508612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Muskego, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2021; 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.