Individual provider Active NPI

Brett Anthony Skinner, D.C.

  • Chiropractor
  • Lexington, KY
National Provider Identifier
1679652622
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4147 Issued in KY
Practice address
3198 Custer Dr # 100
Lexington, KY 40517-4000
Phone
(859) 231-6996
Fax
(859) 255-4104
NPI assigned
Nov 2, 2006
Last updated
Mar 10, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4147 KY Primary

Addresses

Primary practice location

3198 Custer Dr # 100
Lexington, KY 40517-4000

Mailing address

3198 Custer Dr # 100
Lexington, KY 40517-4000
Phone (859) 231-6996

Other identifiers 1

IdentifierTypeStateIssuer
85001071MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060111000881 KY Practitioner - Chiropractic 5698767259 Reassigns benefits to 1 organization
Practice locations: Lexington, KY

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3198 Custer Dr
Suite 100
Lexington, KY 40517-4000
Phone (859) 231-6996

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4147KYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Skinner Wellness Center PLC Chiropractor CurrentSince Feb 26, 2020 Accepting new patients
Northern Kentucky Chiropractic Chiropractor PastSince Jan 1, 1990 Accepting new patients
Skinner Chiropractic Chiropractor PastSince Jan 1, 1990 Accepting new patients
Westside Family Chiropractic Chiropractor PastSince Sep 1, 2007 Accepting new patients
Live Well Chiropractic PSC Chiropractor Past Accepting new patients

Locations

3198 Custer Dr
Ste 100
Lexington, KY 40517
Phone (859) 231-6996

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1679652622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3198 CUSTER DR # 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174000",
            "telephone_number": "859-231-6996",
            "fax_number": "859-255-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3198 CUSTER DR # 100",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174000",
            "telephone_number": "859-231-6996",
            "fax_number": "859-255-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "BRETT",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85001071",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.