Active NPI
Ronald Lee Skertic, PT
- Physical Therapist
- Youngstown, OH
National Provider Identifier
1669406898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 009357
- Practice address
- 299 Edwards Street
Youngstown, OH 44502 - Phone
- (330) 743-1168
- Fax
- (330) 743-1616
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 009357 | OH | Primary |
Addresses
Primary practice location
299 Edwards Street
Youngstown, OH 44502
Mailing address
Everett-Hull Rd
Fowler, OH 44418
Phone (330) 772-4312
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0078348 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 009357 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1669406898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "EVERETT-HULL RD",
"city": "FOWLER",
"state": "OH",
"postal_code": "44418",
"telephone_number": "330-772-4312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "299 EDWARDS STREET",
"city": "YOUNGSTOWN",
"state": "OH",
"postal_code": "44502",
"telephone_number": "330-743-1168",
"fax_number": "330-743-1616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKERTIC",
"first_name": "RONALD",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "009357",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0078348",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Youngstown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.