Jacob Skinner, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

13197 Issued in NV

Practice address

4475 S Eastern Ave
Las Vegas, NV 89119-7826

Phone

(702) 737-1880

Fax

(702) 650-0763

NPI assigned

Apr 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Specialty

Obstetrics/Gynecology

Education

University of Nevada School of Medicine, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Iriye Medical Group PLLCGroup PAC ID 2163415910, 61 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.skinner.1@27017.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1566/brand/2/csg/41/fhir/r4

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.

• Iriye Medical Group PLLC

  • Maternal & Fetal Medicine Physician
  • Las Vegas, NV
  • NPI 1467496240
  Medicare reassignment Care Compare group NPD
• Centennial Hills Hospital Medical Center

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1487771812
  NPD (past)
• Desert Springs Hospital

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1154317964
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1447393152
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1770626426
  NPD (past)
• Henderson Hospital

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1003281452
  NPD (past)
• Sunrise Mountainview Hospital, Inc.

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1831143817
  NPD (past)
• University Medical Center of Southern Nevada

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1548393127
  NPD (past)

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1063686152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1528 W WARM SPRINGS RD STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890144332",
            "telephone_number": "702-737-1880",
            "fax_number": "702-650-0763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4475 S EASTERN AVE",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891197826",
            "telephone_number": "702-737-1880",
            "fax_number": "702-650-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "JACOB",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-18",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "81015",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "13197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063686152",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Skinner, MS, SLP
• Conrad Skinner
• Ebonie Skinner
• Eric S Skinner, DDS
• Jabeirel Skinner
• Jorganne M. Skinner
• Karren Lytlle Skinner
• Kimberley Skinner
• Laquandra M Skinner
• Terri Skinner

• Obstetrics & Gynecology Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Obstetrics & Gynecology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.