Individual provider Active NPI

Kim Noel Skillen, DC

  • Chiropractor
  • Rocky Mount, VA
National Provider Identifier
1073575478
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104001373 Issued in VA
Practice address
546 Pell Avenue
Rocky Mount, VA 24151
Phone
(540) 483-7620
Fax
(540) 483-7739
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104001373 VA Primary

Addresses

Primary practice location

546 Pell Avenue
Rocky Mount, VA 24151

Mailing address

546 Pell Avenue
Rocky Mount, VA 24151
Phone (540) 483-7620

Other identifiers 2

IdentifierTypeStateIssuer
260654OtherVAANTHEM
5900064OtherVAAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126001104 VA Practitioner - Chiropractic 1759560584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Mount Chiropractic IncGroup PAC ID 7416136536, 2 clinicians

Practice addresses (Care Compare)

540 Pell Ave
Rocky Mount, VA 24151-1141

546 Pell Ave
Rocky Mount, VA 24151-1141
Phone (540) 483-7620

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mount Chiropractic Inc Chiropractor CurrentSince Nov 15, 1996 Accepting new patients

Locations

546 Pell Ave
Rocky Mount, VA 24151
Phone (540) 483-7620

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073575478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "546 PELL AVENUE",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "24151",
            "telephone_number": "540-483-7620",
            "fax_number": "540-483-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "546 PELL AVENUE",
            "city": "ROCKY MOUNT",
            "state": "VA",
            "postal_code": "24151",
            "telephone_number": "540-483-7620",
            "fax_number": "540-483-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKILLEN",
        "first_name": "KIM",
        "middle_name": "NOEL",
        "name_prefix": "Mr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "260654",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5900064",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.