Individual provider Active NPI

Skyler Micol Dorius, FNP

  • Family Nurse Practitioner
  • Chubbuck, ID
National Provider Identifier
1740937002
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71861 Issued in ID
Practice address
1641 Cobblestone Ave
Chubbuck, ID 83202-5243
Phone
(208) 760-9238
NPI assigned
Mar 7, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71861 ID Primary

Addresses

Primary practice location

1641 Cobblestone Ave
Chubbuck, ID 83202-5243

Mailing address

1641 Cobblestone Ave
Chubbuck, ID 83202-5243
Phone (208) 760-9238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220609003019 ID Practitioner - Nurse Practitioner 6507244167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175
Phone (208) 239-1720

Hospital & facility affiliations

  • Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Health Services, LLC Current Accepting new patients
Pocatello Health Services, LLC CurrentSince May 23, 2022 Accepting new patients
Pocatello Health Services, LLC CurrentSince May 23, 2022 Accepting new patients
Pocatello Hospital LLC Current Accepting new patients

Locations

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

777 Hospital Way
Ste 115
Pocatello, ID 83201
Phone (208) 239-2260

777 Hospital Way
Ste G15
Pocatello, ID 83201
Phone (208) 239-2260

Interoperability endpoints

  • Direct secure messaging: sdorius264668@ahs.direct-ci.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1740937002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 COBBLESTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025243",
            "telephone_number": "208-760-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 COBBLESTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832025243",
            "telephone_number": "208-760-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORIUS",
        "first_name": "SKYLER",
        "middle_name": "MICOL",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "71861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

Verify at the official NPI Registry.