Individual provider Active NPI

Andrea Dugan Skrocki, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Suttons Bay, MI
National Provider Identifier
1881009892
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704371939 Issued in MI
Practice address
4369 S Scenic View Dr
Suttons Bay, MI 49682-9509
Phone
(406) 493-2371
Fax
(720) 853-0034
NPI assigned
Jun 27, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-APN.0002431-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X C-RXN-0001254-C-NP CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NUR-APRN-LIC-100764 MT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704371939 MI Primary

Addresses

Primary practice location

4369 S Scenic View Dr
Suttons Bay, MI 49682-9509

Mailing address

4369 S Scenic View Dr
Suttons Bay, MI 49682-9509
Phone (406) 493-2371

Other practice location 1

1122 Lincolnwood Rd
Missoula, MT 59802-3037
Phone (720) 853-0030

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
C-APN.0002431-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
C-RXN-0001254-C-NPCOMDPsychiatric/Mental Health Nurse Practitioner
4704371939MIMDPsychiatric/Mental Health Nurse Practitioner
NUR-APRN-LIC-100764MTMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1881009892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4369 S SCENIC VIEW DR",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496829509",
            "telephone_number": "406-493-2371",
            "fax_number": "720-853-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4369 S SCENIC VIEW DR",
            "city": "SUTTONS BAY",
            "state": "MI",
            "postal_code": "496829509",
            "telephone_number": "406-493-2371",
            "fax_number": "720-853-0034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1122 Lincolnwood Rd",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598023037",
            "country_code": "US",
            "telephone_number": "720-853-0030",
            "fax_number": "720-853-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKROCKI",
        "first_name": "ANDREA",
        "middle_name": "DUGAN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-APN.0002431-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "C-RXN-0001254-C-NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "NUR-APRN-LIC-100764",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704371939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suttons Bay, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.