Individual provider Active NPI

Mary Jo Skjoldal, R.O.M.

  • Acupuncturist
  • Bloomsburg, PA
National Provider Identifier
1689714636
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AK000673 Issued in PA
Practice address
227 Center St
Bloomsburg, PA 17815-1701
Phone
(570) 204-6358
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AK000673 PA Primary

Addresses

Primary practice location

227 Center St
Bloomsburg, PA 17815-1701

Mailing address

37 Dragstrip Rd
Catawissa, PA 17820-8712

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

LicenseStateTypeSpecialty
AK000673PAMDAcupuncturist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689714636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 DRAGSTRIP RD",
            "city": "CATAWISSA",
            "state": "PA",
            "postal_code": "178208712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 CENTER ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151701",
            "telephone_number": "570-204-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKJOLDAL",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "R.O.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "AK000673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.