Individual provider Active NPI

Dean D Skinner, D.C.

  • Chiropractor
  • Independence, KY
National Provider Identifier
1114037785
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4327 Issued in KY
Practice address
1922 Walton Nicholson Pike
Independence, KY 41051-7901
Phone
(859) 363-1000
Fax
(859) 363-0836
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4327 KY Primary
Chiropractor 111N00000X X010063-1 NY

Addresses

Primary practice location

1922 Walton Nicholson Pike
Independence, KY 41051-7901

Mailing address

1922 Walton Nicholson Pike
Independence, KY 41051-7901
Phone (859) 363-1000

Other identifiers 1

IdentifierTypeStateIssuer
85001394MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060120000521 KY Practitioner - Chiropractic 9739103425 Reassigns benefits to 1 organization
Practice locations: Independence, KY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1922 Walton Nicholson
Independence, KY 41051
Phone (859) 363-1000

1922 Walton Nicholson Pike
Independence, KY 41051-7901
Phone (859) 363-1000

1922 Walton Nicholson Rd
Independence, KY 41051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4327KYMDChiropractor
X010063-1NYMDChiropractor

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114037785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1922 WALTON NICHOLSON PIKE",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517901",
            "telephone_number": "859-363-1000",
            "fax_number": "859-363-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1922 WALTON NICHOLSON PIKE",
            "city": "INDEPENDENCE",
            "state": "KY",
            "postal_code": "410517901",
            "telephone_number": "859-363-1000",
            "fax_number": "859-363-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "DEAN",
        "middle_name": "D",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4327",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X010063-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001394",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Independence, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.