Individual provider Active NPI

Sean Skinner, MD

  • Pediatric Surgery Physician
  • Lexington, KY
National Provider Identifier
1164562526
Registry record updated Aug 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
42156 Issued in KY
Practice address
800 Rose St
Mn102
Lexington, KY 40536-0298
Phone
(859) 323-5625
Fax
(859) 323-5289
NPI assigned
Feb 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 42156 KY Primary

Addresses

Primary practice location

800 Rose St
Mn102
Lexington, KY 40536-0298

Mailing address

800 Rose St
Mn102
Lexington, KY 40536-0298
Phone (859) 323-5625

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230912002792 FL Practitioner - General Surgery 5294895694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Jun 29, 2023 Accepting new patients
The Nemours Foundation CurrentSince Jun 29, 2023 Accepting new patients
Southern Baptist Hospital of Florida Inc Past Accepting new patients

Locations

10140 Centurion Pkwy N
Jacksonville, FL 32256
Phone (904) 697-4100

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

Interoperability endpoints

  • Direct secure messaging: sskinner18473@ukhcdirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1164562526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "address_2": "MN102",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360298",
            "telephone_number": "859-323-5625",
            "fax_number": "859-323-5289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "address_2": "MN102",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360298",
            "telephone_number": "859-323-5625",
            "fax_number": "859-323-5289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "SEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "KY",
            "license": "42156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.