Active NPI
Kimberly K Skaggs, NP
- Gerontology Nurse Practitioner
- Temple, TX
National Provider Identifier
1104418557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 1019365
- Practice address
- 2401 S 31St St
Temple, TX 76508-0001 - Phone
- (254) 724-2111
- NPI assigned
- Feb 8, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 1019365 | TX | |
| Gerontology Nurse Practitioner | 363LG0600X | 1019365 | TX | Primary |
Addresses
Primary practice location
2401 S 31St St
Temple, TX 76508-0001
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2430 Marketplace Dr
Waco, TX 76711-2453
Phone (254) 981-7900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1019365 | TX | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scott & White Clinic | Current | Accepting new patients | |
| Scott & White Clinic | Current | Accepting new patients | |
| Scott & White Clinic | Current | Accepting new patients |
Locations
101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100
2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459
Interoperability endpoints
- kskaggs14011@direct.sw.org
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Temple, TX
- NPI 1093779704
-
- Physical Medicine & Rehabilitation Physician
- Middle River, MD
- NPI 1710529771
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1649820796
-
- Internal Medicine Physician
- College Station, TX
- NPI 1922061993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670889600000",
"number": "1104418557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658",
"telephone_number": "254-724-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2401 S 31ST ST",
"city": "TEMPLE",
"state": "TX",
"postal_code": "765080001",
"telephone_number": "254-724-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKAGGS",
"first_name": "KIMBERLY",
"middle_name": "K",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2022-12-13",
"certification_date": "2022-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "TX",
"license": "1019365",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "TX",
"license": "1019365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temple, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.