Active NPI
Russell B Skinner, M.D.
- Family Medicine Physician
- Plano, TX
National Provider Identifier
1881698538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- K5697
- Practice address
- 5148 Village Creek Dr
Ste 300
Plano, TX 75093-5064 - Phone
- (469) 661-1100
- Fax
- (469) 661-1100
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K5697 | TX | Primary |
Addresses
Primary practice location
5148 Village Creek Dr
Ste 300
Plano, TX 75093-5064
Mailing address
5148 Village Creek Dr
Ste 300
Plano, TX 75093-5064
Phone (469) 661-1100
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130931208 | Medicaid | TX | |
| 110216569 | Other | TX | RAILROAD MCR # |
| 8A3122 | Other | TX | BCBS IND # |
| K5697 | Other | TX | MEDICAL LICENSE |
| 8X8470 | Other | TX | BCBS WOUND CARE |
| 130931201 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Texas Southwestern Medical School at Dallas, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
5148 Village Creek Dr
Suite 300
Plano, TX 75093-5064
Phone (469) 661-1100
Hospital & facility affiliations
- Unicare Home Health Services
- Senai Home Health Services Inc
- Anointed Home Healthcare Inc.
- Almighty Home Health
- Woori Home Care
- Medical City Plano
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Family Medicine & Psychiatry | Current | Accepting new patients | |
| Russell B Skinner MD PA | Family Medicine | Past | Accepting new patients |
| Central Texas Hyperbarics and Wound | Past | Accepting new patients |
Locations
929 W Pioneer Pkwy
Ste A
Grand Prairie, TX 75051
Phone (972) 433-0088
1801 S Carrier Pkwy
Grand Prairie, TX 75051
Phone (972) 262-5272
Interoperability endpoints
- russell.skinner.1@31232.direct.athenahealth.com
- russell.skinner.1@17636.direct.athenahealth.com
Organizations & group practices 3
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.
-
- Psychiatry Physician
- Grand Prairie, TX
- NPI 1750780235
-
- Family Medicine Physician
- Plano, TX
- NPI 1669849485
-
- Specialist
- Brownwood, TX
- NPI 1245372903
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Plano, TX
- NPI 1316128390
-
- Home Health Agency
- Dallas, TX
- NPI 1033417381
-
- General Acute Care Hospital
- Plano, TX
- NPI 1699726406
-
- Home Health Agency
- Frisco, TX
- NPI 1396792115
-
- Home Health Agency
- Plano, TX
- NPI 1982775060
-
- Home Health Agency
- Tyler, TX
- NPI 1164488334
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650585600000",
"number": "1881698538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5148 VILLAGE CREEK DR",
"address_2": "STE 300",
"city": "PLANO",
"state": "TX",
"postal_code": "750935064",
"telephone_number": "469-661-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5148 VILLAGE CREEK DR",
"address_2": "STE 300",
"city": "PLANO",
"state": "TX",
"postal_code": "750935064",
"telephone_number": "469-661-1100",
"fax_number": "469-661-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "RUSSELL",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2022-04-22",
"certification_date": "2022-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "K5697",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130931208",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MCR #",
"identifier": "110216569",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IND #",
"identifier": "8A3122",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "K5697",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS WOUND CARE",
"identifier": "8X8470",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130931201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.