Mary Susan Clipp, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

2036438 Issued in MN

Practice address

2450 Riverside Ave
Minneapolis, MN 55454-1450

Phone

(612) 365-3100

Fax

(612) 365-3110

NPI assigned

Nov 15, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Dell Children's Medical Group

  • Pediatrics Physician
  • Austin, TX
  • NPI 1326072943
  Medicare reassignment NPD
• Dell Children's Medical Group

  dba Dell Children's Medical Group Sleep Center

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1124748249
  NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1003150194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 HARRIET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554083729",
            "telephone_number": "773-512-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-365-3100",
            "fax_number": "612-365-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIPP",
        "first_name": "MARY",
        "middle_name": "SUSAN",
        "name_prefix": "Mrs.",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MN",
            "license": "2036438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jac Clingerman, LADC
• Clinical Research Institute, Inc
• Joseph Clinton
• Megan Clinton, M.D.
• Krysta Clipp
• Kacey Rae Clipper
• Clockwise Movers LLC
• Clockwise Movers LLC
• Annabel Clodius, MD
• Denis Regis Clohisy, M.D.

• Critical Care Pediatric Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Critical Care Pediatric Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.