Individual provider Active NPI

Lydia Skelley

  • Occupational Therapist
  • North Myrtle Beach, SC
National Provider Identifier
1780813964
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1653 Issued in SC
Practice address
543 Highway 17 N
North Myrtle Beach, SC 29582-2903
Phone
(843) 249-7232
Fax
(843) 280-0206
NPI assigned
Jul 8, 2009
Last updated
Jul 8, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1653 SC Primary

Addresses

Primary practice location

543 Highway 17 N
North Myrtle Beach, SC 29582-2903

Mailing address

543 Highway 17 N
North Myrtle Beach, SC 29582-2903
Phone (843) 249-7232

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1653SCMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1780813964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822903",
            "telephone_number": "843-249-7232",
            "fax_number": "843-280-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 HIGHWAY 17 N",
            "city": "NORTH MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295822903",
            "telephone_number": "843-249-7232",
            "fax_number": "843-280-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELLEY",
        "first_name": "LYDIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "1653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.