Robert Skidmore PHD LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ROBERT SKIDMORE PHD LLC

Practice address

18 Portland Ave
Medford, OR 97504-7309

Phone

(541) 500-8655

NPI assigned

Dec 4, 2018

Organization subpart

No

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

Authorized official

Name

Robert Skidmore, LPCNPI 1942547906

Title

Owner

Phone

(541) 500-8655

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert C Skidmore, PHD, MDIV, MA, LPC

  • Professional Counselor
  • Medford, OR
  • NPI 1942547906
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1720558604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4752",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975010197",
            "telephone_number": "541-500-8655",
            "fax_number": "800-433-1396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PORTLAND AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047309",
            "telephone_number": "541-500-8655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT SKIDMORE PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "SKIDMORE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-500-8655",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500722503",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debra G Robbins, PA-C
• Marlys Hodd Robbins, L.M.T.
• Sarah Anne Roberson, FNP
• Robert L Nutting
• Robert L. Nutting, LLC
• Joseph A Roberts III
• Adrien Roberts
• Cheryl Jean Roberts, FNP
• Shanta Lorien Roberts, PHARMD
• Dacarie Robertson, LCSW

• Professional Counselor in Medford, OR
• Providers in Medford, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.