Individual provider Active NPI

Diane Vail Skojec, CRNP

  • Adult Health Nurse Practitioner
  • Baltimore, MD
National Provider Identifier
1588693733
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R079301 Issued in MD
Practice address
600 N Wolfe St
Blalock 117
Baltimore, MD 21287-0005
Phone
(410) 614-3302
Fax
(410) 614-9983
NPI assigned
Jul 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R079301 MD Primary

Addresses

Primary practice location

600 N Wolfe St
Blalock 117
Baltimore, MD 21287-0005

Mailing address

9709 Deep Smoke
Columbia, MD 21046-2807
Phone (410) 614-3302

Other identifiers 1

IdentifierTypeStateIssuer
402640300MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1588693733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 DEEP SMOKE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210462807",
            "telephone_number": "410-614-3302",
            "fax_number": "410-614-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N WOLFE ST",
            "address_2": "BLALOCK 117",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870005",
            "telephone_number": "410-614-3302",
            "fax_number": "410-614-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOJEC",
        "first_name": "DIANE",
        "middle_name": "VAIL",
        "name_prefix": "Dr.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-01",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R079301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "402640300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.