Individual provider Active NPI

John M Skantz, MD

  • Neurology Physician
  • Milwaukee, WI
National Provider Identifier
1871545699
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
32379 Issued in WI
Practice address
1155 N Mayfair Rd
Spine Care Clinic at Plank Road
Milwaukee, WI 53226-3421
Phone
(414) 955-7199
Fax
(414) 955-0110
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 32379 WI Primary

Addresses

Primary practice location

1155 N Mayfair Rd
Spine Care Clinic at Plank Road
Milwaukee, WI 53226-3421

Mailing address

1155 N Mayfair Rd
Spine Care Clinic at Plank Road
Milwaukee, WI 53226-3421
Phone (414) 955-7199

Other identifiers 2

IdentifierTypeStateIssuer
002000133COtherHUMANA
1871545699MedicaidWI

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32379WIMDNeurology Physician

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412812800000",
    "number": "1871545699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "address_2": "SPINE CARE CLINIC AT PLANK ROAD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263421",
            "telephone_number": "414-955-7199",
            "fax_number": "414-955-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 N MAYFAIR RD",
            "address_2": "SPINE CARE CLINIC AT PLANK ROAD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263421",
            "telephone_number": "414-955-7199",
            "fax_number": "414-955-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKANTZ",
        "first_name": "JOHN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "32379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "002000133C",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871545699",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2014; 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.