Individual provider Active NPI

Mark Sipe

  • Psychiatric/Mental Health Nurse Practitioner
  • Delray Beach, FL
National Provider Identifier
1003265679
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9430045 Issued in FL
Practice address
16158 S Military TRL
Delray Beach, FL 33484-6502
Phone
(561) 495-0522
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 0001242740 VA
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 93000 WV
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 9430045 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 9430045 FL Primary

Addresses

Primary practice location

16158 S Military TRL
Delray Beach, FL 33484-6502

Mailing address

3601 N Military TRL
Boca Raton, FL 33431-5507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20161010002244 FL Practitioner - Nurse Practitioner 3577851427 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001242740VAMDAdult Psychiatric/Mental Health Registered Nurse
93000WVMDAdult Psychiatric/Mental Health Registered Nurse
9430045FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South County Mental Health Center, Inc. CurrentSince Aug 15, 2016 Accepting new patients

Locations

16158 S Military Trl
Delray Beach, FL 33484
Phone (561) 495-0522

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473984000000",
    "number": "1003265679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 N MILITARY TRL",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16158 S MILITARY TRL",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334846502",
            "telephone_number": "561-495-0522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIPE",
        "first_name": "MARK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0001242740",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WV",
            "license": "93000",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "FL",
            "license": "9430045",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9430045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

Verify at the official NPI Registry.