Kevin Skidmore, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801077644 Issued in MI

Practice address

43211 Dalcoma Dr
Suite 7
Clinton Township, MI 48038-6309

Phone

(586) 421-4513

Fax

(586) 948-8416

NPI assigned

Jan 2, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Solution-Based Counseling Services LLCGroup PAC ID 8729267471, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kskidmore784097@direct.hfhs.org

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.

• Solution-Based Counseling Services, LLC

  • Clinical Social Worker
  • Clinton TWP, MI
  • NPI 1669790275
  Medicare reassignment Care Compare group
• Alliance Health Professionals, PLLC

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1841615648
  Medicare reassignment NPD
• Henry Ford Physician Partners

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1427703602
  Medicare reassignment NPD
• Henry Ford Macomb Ancillary Services

  • Clinical Medical Laboratory
  • Mount Clemens, MI
  • NPI 1669864708
  NPD
• Henry Ford Physician Partners

  • Cardiovascular Disease Physician
  • Dearborn, MI
  • NPI 1366219651
  NPD
• Internal Medicine Associates of Mt. Clemens, PC

  • Internal Medicine Physician
  • Mount Clemens, MI
  • NPI 1306842190
  NPD

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

{
    "created_epoch": "1420156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1275921033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43211 DALCOMA DR",
            "address_2": "SUITE 7",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386309",
            "telephone_number": "586-421-4513",
            "fax_number": "586-948-8416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43211 DALCOMA DR",
            "address_2": "SUITE 7",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386309",
            "telephone_number": "586-421-4513",
            "fax_number": "586-948-8416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-01-02",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN LMSW LICENSE",
            "identifier": "6801077644",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunil K Singh, PT
• Steven Paul Singson, D.O.
• Sirisha Koneru, M.D, P.C.
• Emily M Sitarski
• Emily Lynn Siwek, B.S.
• Ian Skinner, D.O.
• Madelyn Slamka
• David Ryan Slapyznski, PA-C
• Janie R Slayden, MA, LLP
• Sleepwell DME LLC

• Clinical Social Worker in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2015; 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.

Verify at the official NPI Registry.