Individual provider Active NPI

Aixa Skelton, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1720139959
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME36752 Issued in FL
Practice address
6911 Merrill Rd
Jacksonville, FL 32277-2616
Phone
(904) 743-1411
Fax
(904) 743-1028
NPI assigned
Jan 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME36752 FL Primary

Addresses

Primary practice location

6911 Merrill Rd
Jacksonville, FL 32277-2616

Mailing address

6911 Merrill Rd
Jacksonville, FL 32277-2616
Phone (904) 743-1411

Other identifiers 1

IdentifierTypeStateIssuer
057688300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041109001120 FL Practitioner - General PracticePractitioner - Pathology 8729041801 Practice locations: Jacksonville, FL

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Pathology
Education
University of Michigan Medical School, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6911 Merrill Rd
Jacksonville, FL 32277-2616
Phone (904) 743-1411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME36752FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Medical Associates, Inc. Family Medicine Past Accepting new patients

Organizations & group practices 1

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": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1720139959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 MERRILL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772616",
            "telephone_number": "904-743-1411",
            "fax_number": "904-743-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6911 MERRILL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772616",
            "telephone_number": "904-743-1411",
            "fax_number": "904-743-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELTON",
        "first_name": "AIXA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME36752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057688300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.