Individual provider Active NPI

Nicholas Adam Skagen, DPT

  • Physical Medicine & Rehabilitation Physician
  • Tuscaloosa, AL
National Provider Identifier
1609596584
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
PTH9030 Issued in AL
Practice address
2201 Jack Warner Pkwy
Tuscaloosa, AL 35401-1090
Phone
(205) 523-5618
Fax
(205) 462-7125
NPI assigned
Aug 31, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X PTH9030 AL Primary

Addresses

Primary practice location

2201 Jack Warner Pkwy
Tuscaloosa, AL 35401-1090

Mailing address

700 High Field Rd
Tuscaloosa, AL 35405-9417
Phone (205) 826-5536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221212001898 AL Practitioner - Physical Therapist in Private Practice 4880063940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

535 Jack Warner Pkwy NE
Tuscaloosa, AL 35404-5715
Phone (205) 826-5536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH9030ALMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flowstate Physical Therapy and Injury Prevention LLC CurrentSince Jul 1, 2024 Accepting new patients
Alpha Neuron, LLC CurrentSince Sep 1, 2022 Accepting new patients
Alpha Neuron, LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

2201 Jack Warner Pkwy
Tuscaloosa, AL 35401
Phone (205) 523-5618

535 Jack Warner Pkwy NE
Ste G2
Tuscaloosa, AL 35404
Phone (205) 507-1264

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1609596584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HIGH FIELD RD",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059417",
            "telephone_number": "205-826-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 JACK WARNER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354011090",
            "telephone_number": "205-523-5618",
            "fax_number": "205-462-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAGEN",
        "first_name": "NICHOLAS",
        "middle_name": "ADAM",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AL",
            "license": "PTH9030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.