Samuel Skidmore, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1-137468 Issued in AL

Practice address

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Phone

(251) 435-5153

NPI assigned

Sep 29, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Horizon Mental Health Management LLCGroup PAC ID 5799674131, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Horizon Mental Health Management LLC

  • Psychiatry Physician
  • Lewisville, TX
  • NPI 1255380176

  AL

  Medicare reassignment Care Compare group

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

• Mobile Infirmary Association

  • General Acute Care Hospital
  • Mobile, AL
  • NPI 1558364802
  Care Compare affiliation

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1710436811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CONWAY DR W",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081740",
            "telephone_number": "251-753-6369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MOBILE INFIRMARY CIR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073513",
            "telephone_number": "251-435-5153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "SAMUEL",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-29",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-137468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Marshall Sitz, D.D.S.
• Hari Krishnan Sivanandam, M.D.
• Six Seven Therapy
• Sydney M Sizemore
• Sizewise Rentals
• Katina Skinner, ALC
• Makyla N Skinner
• Matthew Skinner
• Caitlin Elizabeth Skipper, CRNP
• Dariusz Adam Skladaniec, MD

• Psychiatric/Mental Health Nurse Practitioner in Mobile, AL
• Providers in Mobile, AL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.