Active NPI
Shawn Skinner
- Athletic Trainer
- Indianapolis, IN
National Provider Identifier
1639640519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3476 Oliver Ave
Indianapolis, IN 46241-1610 - Phone
- (219) 363-1546
- NPI assigned
- Dec 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
3476 Oliver Ave
Indianapolis, IN 46241-1610
Mailing address
3476 Oliver Ave
Indianapolis, IN 46241-1610
Phone (219) 363-1546
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545004800000",
"number": "1639640519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3476 OLIVER AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462411610",
"telephone_number": "219-363-1546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3476 OLIVER AVE",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462411610",
"telephone_number": "219-363-1546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "SHAWN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-12-17",
"last_updated": "2018-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.