Active NPI
Richard J. Kipp, D.O.
- Family Medicine Physician
- Sioux City, IA
National Provider Identifier
1003874967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 02233
- Practice address
- 3520 Singing Hills Blvd
Sioux City, IA 51106-5110 - Phone
- (712) 294-7400
- Fax
- (712) 294-7436
- NPI assigned
- May 2, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 02233 | IA | Primary |
Addresses
Primary practice location
3520 Singing Hills Blvd
Sioux City, IA 51106-5110
Mailing address
PO Box 328
Sioux City, IA 51102-0328
Phone (712) 279-5830
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025306900 | Medicaid | IA | |
| 0479816 | Medicaid | IA | |
| 02852 | Other | IA | WELLMARK BCBS IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02233 | IA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Floyd County Memorial Hospital Commission | Family Medicine | Past | Accepting new patients |
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.
-
- Critical Access Hospital
- Charles City, IA
- NPI 1265402390
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347235200000",
"number": "1003874967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 328",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511020328",
"telephone_number": "712-279-5830",
"fax_number": "712-279-5883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3520 SINGING HILLS BLVD",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511065110",
"telephone_number": "712-294-7400",
"fax_number": "712-294-7436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIPP",
"first_name": "RICHARD",
"middle_name": "J.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2012-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "02233",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025306900",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0479816",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS IA",
"identifier": "02852",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.