Individual provider Active NPI

Adrian Rashad Skinner

  • Social Worker
  • Spring, TX
National Provider Identifier
1629202023
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
40921 Issued in TX
Practice address
25715 Serene Spring LN
Spring, TX 77373-8465
Phone
(281) 714-5121
NPI assigned
May 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X 40921 TX Primary

Addresses

Primary practice location

25715 Serene Spring LN
Spring, TX 77373-8465

Mailing address

25715 Serene Spring LN
Spring, TX 77373-8465
Phone (281) 714-5121

Other identifiers 1

IdentifierTypeStateIssuer
180460101MedicaidTX

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
40921TXMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sapphire Therapeutic Services, Inc. Multi-Specialty CurrentSince Oct 20, 2024 Accepting new patients
Ars Resources Social Worker PastSince Oct 20, 2024 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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1629202023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25715 SERENE SPRING LN",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773738465",
            "telephone_number": "281-714-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25715 SERENE SPRING LN",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773738465",
            "telephone_number": "281-714-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "ADRIAN RASHAD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-13",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "TX",
            "license": "40921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "180460101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.