Individual provider Active NPI

Paul Skinner, D.O.

  • Anesthesiology Physician
  • Georgetown, KY
National Provider Identifier
1578555231
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
02414 Issued in KY
Practice address
1140 Lexington Rd
Georgetown, KY 40324-9330
Phone
(502) 868-1100
NPI assigned
Aug 18, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 02414 KY Primary

Addresses

Primary practice location

1140 Lexington Rd
Georgetown, KY 40324-9330

Mailing address

425 Lewis Hargett Cir
Suite 204
Lexington, KY 40503-3590
Phone (859) 268-1030

Other identifiers 1

IdentifierTypeStateIssuer
64024144MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1339WVMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson Memorial Hospital LLC Past Accepting new patients
Bluegrass Anesthesia Services, PSC Anesthesiology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1578555231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 LEWIS HARGETT CIR",
            "address_2": "SUITE 204",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033590",
            "telephone_number": "859-268-1030",
            "fax_number": "859-269-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 LEXINGTON RD",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249330",
            "telephone_number": "502-868-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "PAUL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "02414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64024144",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.