SKYLINE MEDICINE - NPI 1356523492 - Clinic/Center in Mesa, AZ

Q: What is Kerry S Green MD Plc's NPI number?

The NPI number for Kerry S Green MD Plc is 1356523492. It was assigned to this organization in the NPPES registry on November 30, 2007. The provider is doing business as Skyline Medicine.

Q: What is Kerry S Green MD Plc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

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About Skyline Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SKYLINE MEDICINE (NPI 1356523492) is a healthcare organization registered as a clinic/center in Mesa, Arizona and active in the NPI registry since November 2007. The organization lists Kerry Green, Owner, as its authorized official.

NPPES Registry Identity

NPI1356523492

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameKERRY S GREEN MD PLC

Location Address6112 E BROWN RDMesa, AZ 85205-4955

Mailing Address6112 E Brown RdMesa, AZ 85205-4955 · (480) 924-4422

Phone(480) 924-4422

Organization SubpartNo

Authorized OfficialKerry GreenOwner · (480) 924-4422

Enumeration DateNovember 30, 2007

Last NPPES UpdateMarch 8, 2012

✔ NPI 1356523492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in AZ · 29662

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

6112 E BROWN RD, Mesa, AZ 85205

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Other Names 1

Doing Business AsSkyline Medicine

Other Identifiers 2

Medicare PINZ75605AZ

Medicare PINDA7145AZ

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D1056672

Skyline Medicine · Mesa, AZ

Expired · Jul 20, 2026

CLIA Number03D1056672

Laboratory TypePhysician Office

Certificate Effective DateJuly 21, 2024

Certificate Expiration DateJuly 20, 2026

Laboratory DirectorStephen L. Thomas

Laboratory Phone(480) 924-4422

Laboratory LocationSkyline Medicine6112 E Brown Rd, Mesa, AZ 85205

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WS PERRY LLC

Physical Therapist (Orthopedic)

6112 E BROWN RD, SUITE101
MESA, AZ 85205

Maricopa County (480) 827-9707

STEPHEN BAURICHTER PT

Physical Therapist