MR. ROBERT C SKIDMORE PHD, MDIV, MA, LPC
NPI 1942547906
Counselor - Professional in Medford, OR

Q: What is Robert Skidmore's NPI number?

The NPI number for Robert Skidmore is 1942547906. It was assigned to this individual provider in the NPPES registry on January 11, 2013. The provider is also known as Robert Isaac Skidmore Phd, Mdiv, Ma, Lpc.

Q: What is Robert Skidmore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Robert Skidmore was last updated on August 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 11, 2013PECOS Enrolled

18 PORTLAND AVE, MEDFORD, OR 97504(541) 857-0873(541) 245-1530 Get Directions Write a Review

NPPES record last updated: August 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Mr. Robert C Skidmore Phd, Mdiv, Ma, Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ROBERT C SKIDMORE PHD, MDIV, MA, LPC (NPI 1942547906) is an individual professional provider in Medford, Oregon, licensed in Oregon (C3047) and active in the NPI registry since January 2013. He is enrolled in Medicare PECOS and is a graduate of Other (2009).

NPPES Registry Identity

NPI1942547906

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMR. ROBERT C SKIDMORECredential: PHD, MDIV, MA, LPC

Location Address18 PORTLAND AVEMedford, OR 97504-7309

Mailing Address18 Portland AveMedford, OR 97504-7309 · (541) 857-0873 · Fax (541) 245-1530

Phone(541) 857-0873

Fax(541) 245-1530

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateJanuary 11, 2013

Last NPPES UpdateAugust 16, 2025

NPPES CertifiedAugust 16, 2025

✔ NPI 1942547906 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in OR · C3047

18 PORTLAND AVE, Medford, OR 97504

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Other Names 1

Other Name (5)Robert Isaac Skidmore Phd, Mdiv, Ma, Lpc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Robert C Skidmore Phd, Mdiv, Ma, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547793788

PECOS Enrollment IDI20241028001099

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Robert Skidmore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Robert Skidmore Phd LLC

Same address

Professional

18 PORTLAND AVE
Medford, OR 97504

Reassigned Medicare billing, Oregon enrollment

NPI 1720558604 (541) 500-8655

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TORI WILLETT M.S., LPC

Counselor (Professional)