NPIMap

Individual provider Active NPI

Jason Skinner, M.D.

  • Emergency Medicine Physician
  • Conway, AR
National Provider Identifier
1891782959
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E3733 Issued in AR
Practice address
2302 College Ave
Conway, AR 72034-6297
Phone
(501) 513-5793
NPI assigned
Oct 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E3733 AR Primary

Addresses

Primary practice location

2302 College Ave
Conway, AR 72034-6297

Mailing address

2302 College Ave
Conway, AR 72034-6297
Phone (501) 513-5793

Other identifiers 1

IdentifierTypeStateIssuer
150518001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090306000020 AR Practitioner - Emergency Medicine 2466518063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Faulkner Emergency Group, PLLCGroup PAC ID 1557694049, 19 clinicians

Practice addresses (Care Compare)

2302 College Ave
Conway, AR 72034-6297
Phone (501) 329-3831

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E3733ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Regional Medical Center Inc CurrentSince Jul 5, 2003 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Jul 5, 2003 Accepting new patients
Faulkner Emergency Group, PLLC Emergency Medicine CurrentSince May 22, 2019 Accepting new patients
Conway Emergency Physicians, P.a. Past Accepting new patients
Preferred Emergency Specialists, LLC Emergency Medicine Past Accepting new patients
Conway Emergency Physicians, P.a. Past Accepting new patients
Preferred Emergency Specialists, Inc. Emergency Medicine Past Accepting new patients

Locations

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1891782959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-513-5793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E3733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150518001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.