Individual provider Active NPI

Emily Margaret Skoog, M.D.

  • Pediatrics Physician
  • Longview, TX
National Provider Identifier
1942659495
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
S0900 Issued in TX
Practice address
707 Hollybrook Dr
Longview, TX 75605-2410
Phone
(903) 757-6042
Fax
(903) 232-8566
NPI assigned
Jun 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S0900 TX Primary

Addresses

Primary practice location

707 Hollybrook Dr
Longview, TX 75605-2410

Mailing address

707 Hollybrook Dr
Longview, TX 75605-2410
Phone (903) 757-6042

Other identifiers 1

IdentifierTypeStateIssuer
459828601MedicaidTX

Other names 1

  • Emily Johnston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190815003750 AL Practitioner - Pediatric Medicine 6305173139 Reassigns benefits to 1 organization
I20230505002315 TX Practitioner - Pediatric Medicine 6305173139 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC Pediatrics CurrentSince Jul 1, 2019 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Jul 1, 2019 Accepting new patients
Associated Clinicians of East Texas Pediatrics CurrentSince May 1, 2023 Accepting new patients
Longview Medical Center LP Past Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

1600 7th Ave S
Birmingham, AL 35233
Phone (205) 638-9100

703 Volker Hall
Birmingham, AL 35294
Phone (205) 638-9587

707 Hollybrook Dr
Longview, TX 75605
Phone (903) 232-8501

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

Interoperability endpoints

  • Direct secure messaging: emily.skoog.1@23550.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1942659495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 HOLLYBROOK DR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052410",
            "telephone_number": "903-757-6042",
            "fax_number": "903-232-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOOG",
        "first_name": "EMILY",
        "middle_name": "MARGARET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-06",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S0900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "459828601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "JOHNSTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.