Individual provider Active NPI

Chuck Skinner, DMD

  • Dentist
  • Louisville, CO
National Provider Identifier
1154578896
Registry record updated Jan 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10514 Issued in CO
Practice address
1760 Centennial Dr
Louisville, CO 80027-1302
Phone
(303) 665-7505
Fax
(303) 664-9941
NPI assigned
Aug 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10514 CO Primary

Addresses

Primary practice location

1760 Centennial Dr
Louisville, CO 80027-1302

Mailing address

1760 Centennial Dr
Louisville, CO 80027-1302
Phone (303) 665-7505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113002339 CO Order and Referring Only - DentistPractitioner - Dentist 2860794419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10514COMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1154578896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 CENTENNIAL DR",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271302",
            "telephone_number": "303-665-7505",
            "fax_number": "303-664-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 CENTENNIAL DR",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271302",
            "telephone_number": "303-665-7505",
            "fax_number": "303-664-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "CHUCK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-25",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.