Elliot Sebastian Skwerer, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10291 Issued in NC

Practice address

2511 Old Cornwallis Rd
Durham, NC 27713-1869

Phone

(844) 932-5700

NPI assigned

May 4, 2020

Last updated

Nov 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606435200000",
    "number": "1598386302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 BANYON GROVE LOOP",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 OLD CORNWALLIS RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277131869",
            "telephone_number": "844-932-5700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Preston Executive Dr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138433",
            "country_code": "US",
            "telephone_number": "919-297-2930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKWERER",
        "first_name": "ELLIOT",
        "middle_name": "SEBASTIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-11-27",
        "certification_date": "2020-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Kathleen Skinner, LCSW
• Kaitlyn Skipper, MSW, LCSWA
• Jodie Skoff, LCSW
• Irene Belle Skowronek, PH.D.
• Jordan Skowronski, OT
• David Slade, M.D.
• Dennis T. Slade, DDS
• Khalilah Z Slade, LCMHC, LCAS
• Alexis Slater
• Ryan Daniel Slauer, MD

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2020; 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.