Individual provider Active NPI

Mary Frances Skeels, CNS/PMH

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Tyler, TX
National Provider Identifier
1740365527
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
220957 Issued in TX
Practice address
409 W Ferguson St
Tyler, TX 75702-5632
Phone
(903) 596-8353
Fax
(903) 596-9471
NPI assigned
Oct 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X 220957 TX Primary

Addresses

Primary practice location

409 W Ferguson St
Tyler, TX 75702-5632

Mailing address

529 Skipping Stone LN
Tyler, TX 75703-0815
Phone (903) 258-3552

Other identifiers 3

IdentifierTypeStateIssuer
8N8797OtherTXBLUE CROSS BLUE SHIELD
P00318791OtherTXRAIL ROAD
173339602MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462147200000",
    "number": "1740365527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 SKIPPING STONE LN",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030815",
            "telephone_number": "903-258-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W FERGUSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025632",
            "telephone_number": "903-596-8353",
            "fax_number": "903-596-9471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKEELS",
        "first_name": "MARY",
        "middle_name": "FRANCES",
        "name_prefix": "Dr.",
        "credential": "CNS/PMH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "TX",
            "license": "220957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8N8797",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "P00318791",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173339602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2016; 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.