Individual provider Active NPI

Jeffrey Mark Lippold, LVN

  • Licensed Vocational Nurse
  • San Diego, CA
National Provider Identifier
1043545452
Registry record updated Oct 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
VN161495 Issued in CA
Practice address
2300 Front St
210
San Diego, CA 92101-1430
Phone
(858) 733-0581
NPI assigned
Oct 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X VN161495 CA Primary

Addresses

Primary practice location

2300 Front St
210
San Diego, CA 92101-1430

Mailing address

2300 Front St
210
San Diego, CA 92101-1430
Phone (858) 733-0581

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
VN161495CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1254528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254528000000",
    "number": "1043545452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 FRONT ST",
            "address_2": "210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011430",
            "telephone_number": "858-733-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 FRONT ST",
            "address_2": "210",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921011430",
            "telephone_number": "858-733-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPOLD",
        "first_name": "JEFFREY",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-03",
        "last_updated": "2009-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN161495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.