Individual provider Active NPI

Jessin Lynn Skoug, D.C.

  • Chiropractor
  • Wabasha, MN
National Provider Identifier
1669764783
Registry record updated Apr 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5533 Issued in MN
Practice address
131 Main St W
Wabasha, MN 55981-1236
Phone
(651) 565-4863
Fax
(651) 565-4893
NPI assigned
May 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5533 MN Primary
Chiropractor 111N00000X 4754-012 WI

Addresses

Primary practice location

131 Main St W
Wabasha, MN 55981-1236

Mailing address

131 Main St W
Wabasha, MN 55981-1236
Phone (651) 565-4863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000704 MN Practitioner - Chiropractic 0244409936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Valley Chiropractic, LLCGroup PAC ID 9335318021, 3 clinicians

Practice addresses (Care Compare)

131 Main W St
Wabasha, MN 55981-1236
Phone (651) 565-4883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5533MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ruralbasicshc Inc CurrentSince Oct 8, 2016 Accepting new patients
Eagle Valley Chiropractic LLC CurrentSince Jul 5, 2011 Accepting new patients

Locations

106 S Washington St
Lake City, MN 55041
Phone (651) 345-2785

131 Main St W
Wabasha, MN 55981
Phone (651) 565-4863

Organizations & group practices 2

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": "1304812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398729600000",
    "number": "1669764783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MAIN ST W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811236",
            "telephone_number": "651-565-4863",
            "fax_number": "651-565-4893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN ST W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811236",
            "telephone_number": "651-565-4863",
            "fax_number": "651-565-4893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOUG",
        "first_name": "JESSIN",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-08",
        "last_updated": "2014-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5533",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4754-012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabasha, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; 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.