1932143880 NPI number — RONALD P SKIPPER M.D.

Table of content: RONALD P SKIPPER M.D. (NPI 1932143880)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932143880 NPI number — RONALD P SKIPPER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SKIPPER
Provider First Name:
RONALD
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932143880
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2975 HIGHWAY 2 E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUGBY
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58368-7801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-776-5261
Provider Business Mailing Address Fax Number:
701-776-5448

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2975 HIGHWAY 2 E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RUGBY
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58368-7801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
17-765-2617
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  7733 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000083087 . This is a "MEDICARE GROUP NO" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 011001051 . This is a "MEDICARE GROUP#" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 0147577 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00447979 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 0000091398 . This is a "BCBS MT" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".
  • Identifier: 91856 . This is a "BLUE CROSS PROV ID" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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