Active NPI
Michael Skirvin, DDS
- Dentist
- Noblesville, IN
National Provider Identifier
1851658587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12011768A
- Practice address
- 15413 Harmon PL
Noblesville, IN 46060-2148 - Phone
- (317) 698-0648
- NPI assigned
- Apr 19, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 12011768A | IN | Primary |
Addresses
Primary practice location
15413 Harmon PL
Noblesville, IN 46060-2148
Mailing address
15413 Harmon PL
Noblesville, IN 46060-2148
Phone (317) 698-0648
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160128002262 | IN | Order and Referring Only - Dentist | 1456654250 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011768A | IN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334793600000",
"number": "1851658587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15413 HARMON PL",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460602148",
"telephone_number": "317-698-0648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15413 HARMON PL",
"city": "NOBLESVILLE",
"state": "IN",
"postal_code": "460602148",
"telephone_number": "317-698-0648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKIRVIN",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-19",
"last_updated": "2012-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12011768A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Noblesville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.