Kelly Skidmore, MCD-CF-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1000 White Dr
Batesville, AR 72501-2001

Phone

(870) 569-8120

NPI assigned

Dec 30, 2020

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1760079115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1242",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "725561242",
            "telephone_number": "870-291-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WHITE DR",
            "city": "BATESVILLE",
            "state": "AR",
            "postal_code": "725012001",
            "telephone_number": "870-569-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "MCD-CF-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Christopher Simpson, PTA
• Travis Sims, M.D.
• Sanjana Singareddy
• Anup Kumar Singh, MD
• Jason Sinks
• James Skinner, LCSW
• Kathrine Skinner
• Bradley Jordan Slaughter, DDS
• Sloan Eye Clinic
• Sloan Eye Clinic

• Speech-Language Pathologist in Batesville, AR
• Providers in Batesville, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.