Terrance Joseph Skidmore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C8764 Issued in MS

Practice address

1600 Broad Ave
Gulfport, MS 39501-3603

Phone

(228) 865-1330

NPI assigned

Jan 27, 2011

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Medical Systems Management, LLCGroup PAC ID 5092964643, 49 clinicians

Behavioral Consultant Solutions, LLCGroup PAC ID 1951777572, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Behavioral Consultant Solutions, LLC

  • Clinical Social Worker
  • Biloxi, MS
  • NPI 1275282311
  Medicare reassignment Care Compare group NPD
• Medical Systems Management LLC

  dba Rankin Rural Medical Clinic

  • Rural Health Clinic/Center
  • Richland, MS
  • NPI 1740555267

  Clinical

  Medicare reassignment Care Compare group NPD
• Community Wellness and Rehab, LLC

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1093522864
  NPD Authorized official

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1851697635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37161 AUDUBON PARK AVE",
            "city": "GEISMAR",
            "state": "LA",
            "postal_code": "707343265",
            "telephone_number": "337-853-2292",
            "fax_number": "225-313-3563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395013603",
            "telephone_number": "228-865-1330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "37161 Audubon Ave.",
            "address_purpose": "LOCATION",
            "city": "Geismar",
            "state": "LA",
            "postal_code": "70734",
            "country_code": "US",
            "telephone_number": "337-853-2292",
            "fax_number": "225-313-3563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "TERRANCE",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-27",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "8842",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Falon Rene Sisson, FNP (AANP)
• Krystal Lynn Sitthivong, CNP
• Sjturner PLLC
• Amanda Skal
• Sheridan L Skarl, CNM
• Amy Skinner, NP
• Skyline Medical Supply LLC
• Hannah Slade, PCCSS
• Karen Elizabeth Slater, AU.D.
• Rachel Ann Slocum, NP

• Clinical Social Worker in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.