NPIMap

Individual provider Active NPI

Timothy Benjamin Skelton, MD

  • Internal Medicine Physician
  • Biloxi, MS
National Provider Identifier
1598867350
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20528 Issued in MS
Practice address
147 Reynoir St Ste 205
Biloxi, MS 39530-4109
Phone
(228) 702-3020
Fax
(228) 702-3025
NPI assigned
Sep 2, 2006
Last updated
Jun 28, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20528 MS Primary

Addresses

Primary practice location

147 Reynoir St Ste 205
Biloxi, MS 39530-4109

Mailing address

PO Box 550
Ocean Springs, MS 39566-0550
Phone (228) 702-3020

Other identifiers 1

IdentifierTypeStateIssuer
20528OtherMSMISSISSIPPI STATE BOARD OF MEDICAL LICENSURE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090901000319 MS Practitioner - Internal Medicine 0648325498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
East Tennessee State University Quillen College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

12261 Hwy 49
Gulfport, MS 39503-2975
Phone (228) 867-5185

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20528MSMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Singing River Gulfport Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Memorial Hospital at Gulfport Internal Medicine CurrentSince Nov 15, 2021 Accepting new patients
Singing River Gulfport CurrentSince Oct 1, 2020 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Nov 15, 2021 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

147 Reynoir St
Ste 205
Biloxi, MS 39530
Phone (228) 436-1474

147 Reynoir St
Ste 306
Biloxi, MS 39530
Phone (228) 432-1116

1104 Broad Ave
Gulfport, MS 39501
Phone (228) 343-4057

12261 Highway 49
Ste 11
Gulfport, MS 39503
Phone (228) 575-2176

12330 Ashley Dr
Gulfport, MS 39503
Phone (228) 255-8818

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

15200 Community Rd
Gulfport, MS 39503
Phone (228) 575-7000

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

Interoperability endpoints

  • Direct secure messaging: tskelton@direct.mhg.com

Organizations & group practices 8

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 68

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

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1598867350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395660550",
            "telephone_number": "228-702-3020",
            "fax_number": "228-702-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 REYNOIR ST STE 205",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304109",
            "telephone_number": "228-702-3020",
            "fax_number": "228-702-3025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "TIMOTHY",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "20528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSISSIPPI STATE BOARD OF MEDICAL LICENSURE",
            "identifier": "20528",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.