Individual provider Active NPI

Marvin F Skinner, CRNA

  • Certified Registered Nurse Anesthetist
  • Opelika, AL
National Provider Identifier
1710941687
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-030979 Issued in AL
Practice address
2000 Pepperell Pkwy
Opelika, AL 36801-5452
Phone
(334) 528-2499
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

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
Certified Registered Nurse Anesthetist 367500000X 1-030979 AL Primary

Addresses

Primary practice location

2000 Pepperell Pkwy
Opelika, AL 36801-5452

Mailing address

PO Box 235019
Montgomery, AL 36123-5019
Phone (334) 279-1450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100812000033 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668480419 Reassigns benefits to 5 organizations
I20171002000593 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2668480419 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-030979ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Amsol Anesthetists of Georgia, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 21, 2017 Accepting new patients
Sentry Anesthesia Management, LLC CurrentSince Aug 7, 2021 Accepting new patients
Elite Anesthesia Solutions, LLC CurrentSince Feb 1, 2023 Accepting new patients
Community Hospital Inc CurrentSince Feb 20, 2014 Accepting new patients
Ivy Creek Specialty Care Current Accepting new patients
Ivy Creek of Elmore, LLC Current Accepting new patients
Community Hospital Inc CurrentSince Feb 20, 2014 Accepting new patients
Community Hospital Inc Current Accepting new patients
Ivy Creek Specialty Care CurrentSince Dec 1, 2020 Accepting new patients
Amsol Anesthetists of Georgia LLC-Hughston Surgical Center Nurse Anesthetist, Certified Registered CurrentSince Feb 21, 2017 Accepting new patients
Premier Anesthesia of Montgomery PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

201 Mariarden Rd
Dadeville, AL 36853
Phone (256) 825-0677

7956 Vaughn Rd
Ste 165
Montgomery, AL 36116

4401 Riverchase Dr
Phenix City, AL 36867
Phone (334) 732-3000

805 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-6541

4800 48th St
Valley, AL 36854
Phone (334) 756-1401

500 Hospital Dr
Wetumpka, AL 36092
Phone (334) 283-2542

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

100 Frist Ct
Columbus, GA 31909
Phone (706) 494-2100

2421 Brookstone Centre Pkwy
Columbus, GA 31904

710 Center St
Columbus, GA 31901
Phone (706) 571-1000

811 22nd St
Columbus, GA 31904
Phone (706) 323-1054

1224 Stark Ave
Columbus, GA 31906
Phone (706) 243-7010

1900 10th Ave
Ste 300
Columbus, GA 31901
Phone (706) 341-3311

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Organizations & group practices 11

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710941687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 235019",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361235019",
            "telephone_number": "334-279-1450",
            "fax_number": "334-279-1660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PEPPERELL PKWY",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368015452",
            "telephone_number": "334-528-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "MARVIN",
        "middle_name": "F",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-030979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelika, AL

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.