Individual provider Active NPI

Ryan Hunter Skidmore, FNP-C

  • Family Nurse Practitioner
  • Charleston, WV
National Provider Identifier
1568284206
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
111629 Issued in WV
Practice address
3100 Maccorkle Ave SE Ste 700
Charleston, WV 25304-1230
Phone
(304) 351-1600
Fax
(304) 351-1664
NPI assigned
Oct 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 111629 WV Primary

Addresses

Primary practice location

3100 Maccorkle Ave SE Ste 700
Charleston, WV 25304-1230

Mailing address

3100 Maccorkle Ave SE
Suite 700
Charleston, WV 25304-1230
Phone (304) 351-1600

Other practice location 1

1306 Kanawha Blvd E
Charleston, WV 25301-3001
Phone (304) 343-4371

Other practice location 2

1400 Hospital Dr
Hurricane, WV 25526-9202
Phone (304) 757-1700

Other practice location 3

3200 MacCorkle Ave SE
Charleston, WV 25304-1227
Phone (304) 388-5432

Other practice location 4

800 Pennsylvania Ave
Charleston, WV 25302-3351
Phone (304) 388-4432

Other practice location 5

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Other practice location 6

1220 Lee Street, E
Charleston, WV 25301
Phone (304) 388-1800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ryan.skidmore@vandaliahealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014000068 WV Practitioner - Nurse Practitioner 0042707135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3100 Maccorkle Ave SE
Suite 700a
Charleston, WV 25304-1223
Phone (304) 351-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
111629WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. CurrentSince Jul 11, 2025 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Jul 11, 2025 Accepting new patients

Locations

3100 Maccorkle Ave SE
Ste 700
Charleston, WV 25304
Phone (304) 351-1500

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

1306 Kanawha Blvd E
Charleston, WV 25301
Phone (304) 343-4371

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

1400 Hospital Dr
Hurricane, WV 25526
Phone (304) 757-1700

Organizations & group practices 2

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1568284206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE",
            "address_2": "SUITE 700",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041230",
            "telephone_number": "304-351-1600",
            "fax_number": "304-351-1664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 MACCORKLE AVE SE STE 700",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041230",
            "telephone_number": "304-351-1600",
            "fax_number": "304-351-1664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1306 Kanawha Blvd E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253013001",
            "country_code": "US",
            "telephone_number": "304-343-4371",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "WV",
            "postal_code": "255269202",
            "country_code": "US",
            "telephone_number": "304-757-1700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3200 MacCorkle Ave SE",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253041227",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023351",
            "country_code": "US",
            "telephone_number": "304-388-4432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 Morris St",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253011326",
            "country_code": "US",
            "telephone_number": "304-388-5432",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1220 Lee Street, E",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "25301",
            "country_code": "US",
            "telephone_number": "304-388-1800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "RYAN",
        "middle_name": "HUNTER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-24",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "111629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ryan.skidmore@vandaliahealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3100 MacCorkle Ave SE Ste 700",
            "city": "Charleston",
            "state": "WV",
            "country_code": "US",
            "postal_code": "253041230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.