Active NPI
Ryan Gregory Skinner, DO
- Family Medicine Physician
- Holloman Air Force Base, NM
National Provider Identifier
1699472282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2025033610
- Practice address
- 280 David L Goldfein St
Holloman Air Force Base, NM 88330-8273 - Phone
- (575) 572-2778
- NPI assigned
- Feb 14, 2023
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2025033610 | MO | Primary |
Addresses
Primary practice location
280 David L Goldfein St
Holloman Air Force Base, NM 88330-8273
Mailing address
280 David L Goldfein St
Holloman Air Force Base, NM 88330-8273
Phone (575) 572-2778
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241107000993 | IL | Order and Referring Only - Family Practice | 6305370776 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.082940 | IL | MD | Military Health Care Provider |
Interoperability endpoints
- ryan.skinner.1@9559.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782086400000",
"number": "1699472282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 DAVID L GOLDFEIN ST",
"city": "HOLLOMAN AIR FORCE BASE",
"state": "NM",
"postal_code": "883308273",
"telephone_number": "575-572-2778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 DAVID L GOLDFEIN ST",
"city": "HOLLOMAN AIR FORCE BASE",
"state": "NM",
"postal_code": "883308273",
"telephone_number": "575-572-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "RYAN",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-14",
"last_updated": "2026-06-22",
"certification_date": "2026-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2025033610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holloman Air Force Base, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.