Individual provider Active NPI

Jay Skaggs

  • Mental Health Counselor
  • Battle Creek, MI
National Provider Identifier
1811224637
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401011644 Issued in MI
Practice address
140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone
(269) 966-1460
Fax
(269) 979-7766
NPI assigned
Nov 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401011644 MI Primary

Addresses

Primary practice location

140 Michigan Ave W
Battle Creek, MI 49017-3602

Mailing address

140 Michigan Ave W
Battle Creek, MI 49017-3602
Phone (269) 966-1460

Other identifiers 1

IdentifierTypeStateIssuer
6401011644OtherMILICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231213003287 MI Practitioner - Mental Health Counselor 6103275318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Desert Streams P CGroup PAC ID 2961446273, 13 clinicians

Practice addresses (Care Compare)

2019 Rambling Rd
Kalamazoo, MI 49008-1630
Phone (269) 345-0909

9 Heritage Oak LN
Battle Creek, MI 49015-4281
Phone (268) 345-0909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401011644MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Streams P C Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2019 Rambling Rd
Kalamazoo, MI 49008
Phone (269) 345-0909

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": "1258329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258329600000",
    "number": "1811224637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-979-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MICHIGAN AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173602",
            "telephone_number": "269-966-1460",
            "fax_number": "269-979-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKAGGS",
        "first_name": "JAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-16",
        "last_updated": "2009-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401011644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "6401011644",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

Verify at the official NPI Registry.