Individual provider Active NPI

Carl Skinner, MD

  • Emergency Medicine Physician
  • Tacoma, WA
National Provider Identifier
1558352203
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5560815-1205 Issued in UT
Practice address
Madigan Army Medical Ctr
Department of Emergency Medicine
Tacoma, WA 98431-0001
Phone
(253) 968-1250
NPI assigned
Nov 2, 2005
Last updated
Apr 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5560815-1205 UT Primary
Medical Toxicology (Emergency Medicine) Physician 207PT0002X MD 60148992 WA

Addresses

Primary practice location

Madigan Army Medical Ctr
Department of Emergency Medicine
Tacoma, WA 98431-0001

Mailing address

Madigan Army Medical Ctr
Department of Emergency Medicine
Tacoma, WA 98431-0001
Phone (253) 968-1250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230410002343 UT Practitioner - Emergency Medicine 2365543956 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3451 W 5600
Roy, UT 84067-9112
Phone (801) 896-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD 60148992WAMDMedical Toxicology (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
Emergency Physicians Integrated Care, LLC Emergency Medicine CurrentSince Jun 4, 2023 Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2023 Accepting new patients
University of Utah Adult Services CurrentSince May 1, 2023 Accepting new patients

Locations

2690 N 600 W
Pleasant View, UT 84414
Phone (801) 786-7911

3451 W 5600 S
Roy, UT 84067
Phone (801) 896-5600

333 N 300 W
Salt Lake City, UT 84103
Phone (801) 463-7415

1050 E South Temple
Slc, UT 84102
Phone (801) 350-4111

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1558352203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "5560815-1205",
            "primary": true
        },
        {
            "code": "207PT0002X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Medical Toxicology",
            "state": "WA",
            "license": "MD 60148992",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.