Individual provider Active NPI

Cody A. Skinner, MD

  • Anesthesiology Physician
  • Grand Junction, CO
National Provider Identifier
1629046750
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
47127 Issued in CO
Practice address
2635 N 7TH St
Grand Junction, CO 81501-8209
Phone
(970) 244-2273
NPI assigned
Mar 14, 2006
Last updated
Dec 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2005-0106 NM
Anesthesiology Physician 207L00000X 47127 CO Primary

Addresses

Primary practice location

2635 N 7TH St
Grand Junction, CO 81501-8209

Mailing address

1120 Wellington Ave
Suite 206
Grand Junction, CO 81501-6131
Phone (970) 243-7245

Other identifiers 2

IdentifierTypeStateIssuer
14327597MedicaidCO
40702081MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20090804000033 CO Practitioner - Anesthesiology 9436186723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Consultants of Western Colorado, PLLCGroup PAC ID 8921995754, 28 clinicians

Practice addresses (Care Compare)

2635 N 7TH St
Grand Junction, CO 81501-8209
Phone (970) 298-2273

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47127COMDAnesthesiology Physician
2005-0106NMMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Anesthesia Consultants of Western Colorado LLC Anesthesiology CurrentSince Jul 13, 2009 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1120 Wellington Ave
Ste 206
Grand Junction, CO 81501
Phone (970) 243-7245

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

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 4

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1629046750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WELLINGTON AVE",
            "address_2": "SUITE 206",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016131",
            "telephone_number": "970-243-7245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 N 7TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018209",
            "telephone_number": "970-244-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "CODY",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NM",
            "license": "2005-0106",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CO",
            "license": "47127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14327597",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40702081",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.