Active NPI
Jodie Lynn Skillicorn, D.O.
- Psychiatry Physician
- Fairlawn, OH
National Provider Identifier
1922298843
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 34008924
- Practice address
- 3610 West Market Street
Fairlawn, OH 44333-9301 - Phone
- (330) 715-9282
- Fax
- (330) 752-2541
- NPI assigned
- Jul 26, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 34008924 | OH | Primary |
Addresses
Primary practice location
3610 West Market Street
Fairlawn, OH 44333-9301
Mailing address
3610 West Market Street
Suite 102
Fairlawn, OH 44333-9301
Phone (330) 715-9282
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 Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319673600000",
"number": "1922298843",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3610 WEST MARKET STREET",
"address_2": "SUITE 102",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443339301",
"telephone_number": "330-715-9282",
"fax_number": "330-752-2541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3610 WEST MARKET STREET",
"city": "FAIRLAWN",
"state": "OH",
"postal_code": "443339301",
"telephone_number": "330-715-9282",
"fax_number": "330-752-2541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKILLICORN",
"first_name": "JODIE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-26",
"last_updated": "2011-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "OH",
"license": "34008924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairlawn, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.