ROBERT SKIDMORE PHD LLC (NPI# 1720558604) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720558604 |
| Entity Type | Organization |
| Organization Name | ROBERT SKIDMORE PHD LLC |
| Practice Address |
18 Portland Ave Medford OR 97504-7309 |
| Mailing Address |
Po Box 4752 Medford OR 97501-0197 |
| Practice Telephone | 5415008655 |
| Mailing Telephone | 5415008655 |
| Mailing Fax Number | 8004331396 |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2018-12-04 |
| Authorized Official Name | ROBERT SKIDMORE (OWNER) |
| Authorized Official Telephone | 5415008655 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 500722503 | 05 |
| Street Address |
18 PORTLAND AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447221494 | Bernard Leo Legner | Marriage & Family Therapist | 18 Portland Ave, Medford, OR 97504-7309 | 2006-01-29 |
| 1942547906 | Robert C Skidmore | Counselor | 18 Portland Ave, Medford, OR 97504-7309 | 2013-01-11 |
| 1831444611 | Robert L. Nutting, LLC | Massage Therapist | 18 Portland Ave, Medford, OR 97504-7309 | 2012-07-18 |
| 1528355112 | Edward James Reed | Counselor | 18 Portland Ave, Medford, OR 97504-7309 | 2011-07-01 |
| 1831375617 | Jeffrey Adam Williamson | Counselor | 18 Portland Ave, Medford, OR 97504-7309 | 2008-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457978017 | Peaceful Practices Counseling LLC | Counselor | 520 Stokes Rd Ste A5, Medford, NJ 08055-2904 | 2020-06-30 |
| 1962972463 | Karen Elise Roertgen | Counselor | 328 So. Central Ave., Suite 204, Medford, OR 97501 | 2018-11-28 |
| 1861998080 | Deborah Hritz | Counselor | 13 Larsen Park Dr, Medford, NJ 08055-8169 | 2018-04-05 |
| 1396112678 | Sara Marie Martino | Counselor | 19 Ohio Trl, Medford, NJ 08055-8931 | 2015-08-21 |
| 1437568417 | Angela R Ewing | Counselor | 33 N Central Ave Ste 400, Medford, OR 97501-5940 | 2014-08-04 |
| 1609200567 | Professional Psychology Services | Counselor | 1 N Main St Ste 1b, Medford, NJ 08055-2445 | 2013-08-28 |
| 1609172717 | Lisa N Ortiz | Counselor | 328 S Central Ave Ste 110, Medford, OR 97501-7274 | 2011-02-07 |
| 1902101066 | Susan Desantis Marion | Counselor | 1005 East Main Street, Jackson County Mental Health, Medford, OR 97504 | 2011-01-21 |
| 1972711042 | Mary Catherine Martin | Counselor | 3550 National Drive, Medford, OR 97504 | 2007-05-20 |
| 1922210020 | Jacqueline A Buckmaster | Counselor | 1016 Court St., Medford, OR 97501 | 2007-05-03 |
| Find all providers in MEDFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.