J. Mark Skaggs, PT, CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070-005333 Issued in IL

Practice address

103 N Benton St
Winnebago, IL 61088-9501

Phone

(815) 335-5223

Fax

(815) 335-5224

NPI assigned

Aug 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ortho Rehab Specialists PLLCGroup PAC ID 8527492354, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ortho Rehab Specialists PLLC

  • Physical Therapist
  • Rockford, IL
  • NPI 1891330882
  Medicare reassignment Care Compare group NPD
• Orthopedic Rehab Specialists of Dixon, LLC

  • Physical Therapist
  • Dixon, IL
  • NPI 1679778435
  NPD

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1710995337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 MCFARLAND RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076806",
            "telephone_number": "815-227-1700",
            "fax_number": "815-227-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N BENTON ST",
            "city": "WINNEBAGO",
            "state": "IL",
            "postal_code": "610889501",
            "telephone_number": "815-335-5223",
            "fax_number": "815-335-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAGGS",
        "first_name": "J.",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "PT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070-005333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "070-005333",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hahn Tu Rudolph, DO
• Julie Rylatt, LCSW
• Sabra Illinois Operations I, LLC
• Andrew Joseph Sartino, PT
• Kaili T Simmons, DPT
• Lori A Stanton, MS.ED, CADC, LCPC
• Jon S. Strutzenberg, DO
• Christina Marie Warden
• Win Bur Sew Fire Protection Dist
• Winnebago Cusd 323

• Physical Therapist in Winnebago, IL
• Providers in Winnebago, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.