Robert C Skidmore, PHD, MDIV, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C3047 Issued in OR

Practice address

18 Portland Ave
Medford, OR 97504-7309

Phone

(541) 857-0873

Fax

(541) 245-1530

NPI assigned

Jan 11, 2013

Last updated

Aug 16, 2025By the provider in NPPES

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 names 1

• Robert Isaac Skidmore Other name

Medicare fee-for-service enrollment

Enrolled in OR

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

Mental Health Counselor

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Philosophy

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.

• Robert Skidmore PHD LLC

  • Professional Counselor
  • Medford, OR
  • NPI 1720558604
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755302400000",
    "number": "1942547906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PORTLAND AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047309",
            "telephone_number": "541-857-0873",
            "fax_number": "541-245-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 PORTLAND AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047309",
            "telephone_number": "541-857-0873",
            "fax_number": "541-245-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKIDMORE",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "PHD, MDIV, MA, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-11",
        "last_updated": "2025-08-16",
        "certification_date": "2025-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C3047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERT",
            "last_name": "SKIDMORE",
            "middle_name": "ISAAC",
            "credential": "PHD, MDIV, MA, LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Medford, OR
• Providers in Medford, OR by specialty
• Professional Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2025; 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.