Robert Gerard Skelley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1672 Issued in IA

Practice address

204 N Arcade St
Maquoketa, IA 52060-2022

Phone

(563) 652-5603

Fax

(563) 323-0949

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eye Care Pavilion PLC

  • Optometrist
  • Davenport, IA
  • NPI 1083684211
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1700866282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520600670",
            "telephone_number": "563-652-5603",
            "fax_number": "563-323-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N ARCADE ST",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602022",
            "telephone_number": "563-652-5603",
            "fax_number": "563-323-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELLEY",
        "first_name": "ROBERT",
        "middle_name": "GERARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IA",
            "license": "1672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA",
            "identifier": "21524",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156133",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IOWA",
            "identifier": "37836",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2156133",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia M Schveiger, RN, IBCLC, RLC
• Mary Virginia Schwartz, LMHC
• Donald Lynn Schwenker, D.C
• Pamela Jean Severson, LMHC
• Shelby Lynn Shedenhelm, CCC-SLP
• Brittany Joan Skorek, LMSW
• Smiles on Main
• Richard Kindle Smith, CRNA
• Alayna Terasa Soto, BA, TCADC
• Angela Michelle Spannagel, PHARMD

• Optometrist in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• Optometrist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.

Verify at the official NPI Registry.