Active NPI
Michael John Skeltis Sr.
- Foster Care Agency
- Hazel Park, MI
National Provider Identifier
1639693690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foster Care Agency
- Practice address
- 23715 Crossley Ave
Hazel Park, MI 48030-1605 - Phone
- (248) 439-6291
- NPI assigned
- Aug 1, 2017
- 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 |
|---|---|---|---|---|
| Foster Care Agency | 253J00000X | Primary |
Addresses
Primary practice location
23715 Crossley Ave
Hazel Park, MI 48030-1605
Mailing address
23715 Crossley Ave
Hazel Park, MI 48030-1605
Phone (248) 439-6291
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": "1501545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1639693690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23715 CROSSLEY AVE",
"city": "HAZEL PARK",
"state": "MI",
"postal_code": "480301605",
"telephone_number": "248-439-6291"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23715 CROSSLEY AVE",
"city": "HAZEL PARK",
"state": "MI",
"postal_code": "480301605",
"telephone_number": "248-439-6291"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKELTIS",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-08-01",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hazel Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.