Sharon B Skidmore, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2623 Issued in OR

Practice address

1109 N Forest Edge Dr
Sisters, OR 97759-2692

Phone

(907) 346-4096

Fax

(877) 319-7365

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy for Kids, LLC

  • Physical Therapy Clinic/Center
  • Sisters, OR
  • NPI 1013240175

  Physical Therapist

  NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1215036751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977591475",
            "telephone_number": "907-346-4096",
            "fax_number": "877-319-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N FOREST EDGE DR",
            "city": "SISTERS",
            "state": "OR",
            "postal_code": "977592692",
            "telephone_number": "907-346-4096",
            "fax_number": "877-319-7365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Business Park Blvd Bldg D-24",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995037142",
            "country_code": "US",
            "telephone_number": "907-346-4096",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "SHARON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "783",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "10338",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0003243",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AK",
            "license": "783",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OR",
            "license": "2623",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CO",
            "license": "PTL.0003243",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "2623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OR BOARD OF PHYSICAL THERAPY",
            "identifier": "2623",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029669",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA BOARD OF PT AND OT",
            "identifier": "783",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO DEPARTMENT OF REGULARTORY AGENCIES",
            "identifier": "PTL.0003243",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500783631",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Edward Seitzinger, LMT
• She Soars Psychiatry, LLC
• Sisters Oregon MD LLC
• Sisters Physical Therapy, LLC.
• Sisters Rural Fire Protection District
• Amanda Michelle Smith
• Jennifer Elizabeth Sowers, LPC
• St. Charles Health System, Inc.
• Angela Marie Stahancyk, RDH, BS
• Step & Spine Physical Therapy LLC

• Physical Therapist in Sisters, OR
• Providers in Sisters, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.