Penny Skidmore, RN,BSN,CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

48790 Issued in WV

Practice address

1 Harbour Way
Milton, WV 25541-1545

Phone

(304) 743-1407

Fax

(304) 743-4516

NPI assigned

Jun 23, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1326420704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HARBOUR WAY",
            "city": "MILTON",
            "state": "WV",
            "postal_code": "255411545",
            "telephone_number": "304-743-1407",
            "fax_number": "304-743-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "PENNY",
        "credential": "RN,BSN,CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "48790",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "WV",
            "license": "48790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virginia C Shiltz, LMT-2005-1946
• Coley C Shinn
• Gregory C Shuler
• D'Angelo Simpson
• Molly E Simpson
• Amy Skonberg
• Jennifer Slash
• Jessica L Slash
• Maggie J Slate
• Andrea Smith

• Diabetes Educator Registered Nurse in Milton, WV
• Providers in Milton, WV by specialty
• Diabetes Educator Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.