Jenifer Renee Skeans, CSFA

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

171496 Issued in OK

Practice address

6515 S. 250TH East Ave
Broken Arrow, OK 74014

Phone

(918) 289-8422

Fax

(918) 286-0077

NPI assigned

Jul 25, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Renee Clay Skeans Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1972768299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 S. 250TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74014",
            "telephone_number": "918-289-8422",
            "fax_number": "918-286-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 S. 250TH EAST AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "74014",
            "telephone_number": "918-289-8422",
            "fax_number": "918-286-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKEANS",
        "first_name": "JENIFER",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "CSFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "OK",
            "license": "171496",
            "primary": true
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "CLAY SKEANS",
            "middle_name": "RENEE",
            "credential": "CSFA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dianne Sitz
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• Amanda Skvortsov, APRN
• Skye Horizon Mental Health LLC
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• Surgical Technologist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Surgical Technologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.