Jibril Dixon Skaden, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME133396 Issued in FL

Practice address

855 E Plant St Ste 100
Winter Garden, FL 34787-3160

Phone

(407) 287-6363

Fax

(844) 388-6186

NPI assigned

Jul 30, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Florida Medical Associates LLC

  dba VIPcare

  • Primary Care Clinic/Center
  • Lady Lake, FL
  • NPI 1336153709
  Medicare reassignment NPD
• North Brevard Medical Support, Inc

  dba Parrish Medical Group

  • Multi-Specialty Clinic/Center
  • Titusville, FL
  • NPI 1609834886
  Medicare reassignment NPD

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1902281025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "727-322-3439",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 E PLANT ST STE 100",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347873160",
            "telephone_number": "407-287-6363",
            "fax_number": "844-388-6186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKADEN",
        "first_name": "JIBRIL",
        "middle_name": "DIXON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME133396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023627300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Simple Pathways Counseling Inc
• Carolyne Marie Singh, PA-C
• Kiran Singh
• Melanie Singh
• Selena Sharda Singh
• Autumn Marie Skates
• Skilled for Life
• Kara Sleeper, PHARMD
• Josephine Anne Sloman, FNP-C
• Smilexp PLLC (The Smile Home)

• Family Medicine Physician in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.