Individual provider Active NPI

Jordan Elizabeth Kipp, PA-C

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1043995137
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA200001715 Issued in DC
Practice address
2041 Georgia Ave NW
Washington, DC 20060-1901
Phone
(412) 852-2935
NPI assigned
Jun 16, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA200001715 DC Primary

Addresses

Primary practice location

2041 Georgia Ave NW
Washington, DC 20060-1901

Mailing address

119 Allegheny Dr
Natrona Heights, PA 15065-1901

Other practice location 1

119 Allegheny Dr
Natrona Heights, PA 15065-1901
Phone (412) 852-2935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20230928000315 DC Practitioner - Physician Assistant 4587018304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA200001715DCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America, LLC CurrentSince Oct 1, 2023 Accepting new patients
Cep America LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1150 Varnum St NE
Washington, DC 20017
Phone (202) 269-7000

2041 Georgia Ave NW
Washington, DC 20060
Phone (202) 865-3785

Organizations & group practices 3

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": "1686873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1043995137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 ALLEGHENY DR",
            "city": "NATRONA HEIGHTS",
            "state": "PA",
            "postal_code": "150651901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200601901",
            "telephone_number": "412-852-2935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "119 Allegheny Dr",
            "address_purpose": "LOCATION",
            "city": "Natrona Heights",
            "state": "PA",
            "postal_code": "150651901",
            "country_code": "US",
            "telephone_number": "412-852-2935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIPP",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-16",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA200001715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.