Kentucky Skin Cancer Center PLLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

KENTUCKY SKIN CANCER CENTER PLLC

Practice address

1818 Wallace Court
Suite 301
Bowling Green, KY 42103

Phone

(270) 907-3030

NPI assigned

Mar 30, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Skaggs II, MDNPI 1821435074

Title

Owner

Phone

(270) 907-3030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Louis Skaggs II, M.D.

  • MOHS-Micrographic Surgery Physician
  • Bowling Green, KY
  • NPI 1821435074

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Cortney Jean Higdon, APRN

  • Family Nurse Practitioner
  • Owensboro, KY
  • NPI 1760076863
  Medicare reassignment Care Compare group NPD
• Leslie Brooke Mills, DO

  • Dermatology Physician
  • Bowling Green, KY
  • NPI 1497000723
  Medicare reassignment Care Compare group NPD
• Kathy Lynne Vincent, APRN, NP-BC

  • Nurse Practitioner
  • Providence, KY
  • NPI 1598060899
  Medicare reassignment Care Compare group NPD
• Anne Taylor Beck, MD

  • Dermatology Physician
  • Columbia, MO
  • NPI 1508425935

  KY

  Medicare reassignment Care Compare group NPD
• Ryan Bogner, M.D.

  • Dermatology Physician
  • New Albany, IN
  • NPI 1225440324

  KY

  Medicare reassignment Care Compare group NPD
• Ryan Ladd, MD

  • MOHS-Micrographic Surgery Physician
  • Rochester, MN
  • NPI 1508494592

  KY

  Medicare reassignment Care Compare group NPD
• Kenneth James Minielly, M.D.

  • Dermatology Physician
  • Springfield, IL
  • NPI 1699125062

  KY

  Medicare reassignment Care Compare group NPD
• Clay A. Carter, PA

  • Physician Assistant
  • Owensboro, KY
  • NPI 1639726938
  Medicare reassignment Care Compare group
• Ashley Brianna Clemons, PA

  • Medical Physician Assistant
  • Lexington, KY
  • NPI 1811746043
  Medicare reassignment Care Compare group
• Leslie Pemberton, PA-C

  • Physician Assistant
  • Owensboro, KY
  • NPI 1003311036
  Medicare reassignment Care Compare group
• Kelsey Leigh Wright, PA

  • Physician Assistant
  • Owensboro, KY
  • NPI 1326515529
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1902302987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 WALLACE COURT",
            "address_2": "SUITE 301",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 WALLACE COURT",
            "address_2": "SUITE 301",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "42103",
            "telephone_number": "270-907-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKY SKIN CANCER CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "SKAGGS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-907-3030",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kentucky CVS Pharmacy, L.L.C. (CVS Pharmacy # 06422)
• Kentucky Em-I Medical Services PSC
• Kentucky Physicians Eyecare Group, P.S.C.
• Kentucky Telehealth Therapy LLC
• Kentucky Trauma Therapists, LLC
• William Boyd Kernodle
• Allison J Kerr, O.D.
• Amber Kerr

• MOHS-Micrographic Surgery Physician in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• MOHS-Micrographic Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.