Stephanie Katherine Skelly, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32063 Issued in NE

Practice address

2817 Rock Merritt Avenue
Fort Liberty, NC 28310-7141

Phone

(910) 907-8500

Fax

(910) 907-8630

NPI assigned

Apr 6, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1972000925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8500",
            "fax_number": "910-907-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283107141",
            "telephone_number": "910-907-8500",
            "fax_number": "910-907-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKELLY",
        "first_name": "STEPHANIE",
        "middle_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "32063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Davis Sherin
• Hugh McKinnon Sherrill, DDS
• Glenn Curtis Simpson III, CRNA
• Alicia Sinclair
• Maxwell R Sirkin, M.D.
• Lantz Smith
• Tamekia Smith X, BSN, RN
• Kaliah Amari' Sparrow, PA-C
• Keisha Lashawn Speller-Person
• Mark Allen Staal, PH.D

• Family Medicine Physician in Fort Liberty, NC
• Providers in Fort Liberty, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.