Individual provider Active NPI

Thomas Stanley Lipscomb, M.D.

  • Pediatric Radiology Physician
  • Fort Worth, TX
National Provider Identifier
1053633727
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
D-1704 Issued in TX
Practice address
4251 Sarita CT
Fort Worth, TX 76109-4732
Phone
(817) 923-1163
Fax
(817) 924-3748
NPI assigned
Feb 23, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X D-1704 TX Primary

Addresses

Primary practice location

4251 Sarita CT
Fort Worth, TX 76109-4732

Mailing address

4251 Sarita Court
Fort Worth, TX 76109-4732
Phone (817) 923-1163

Other names 1

  • Dr. Tom S. Lipscomb Other name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D-1704TXMDPediatric Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1266883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1053633727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 SARITA COURT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094732",
            "telephone_number": "817-923-1163",
            "fax_number": "817-924-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 SARITA CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094732",
            "telephone_number": "817-923-1163",
            "fax_number": "817-924-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSCOMB",
        "first_name": "THOMAS",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-23",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "TX",
            "license": "D-1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOM",
            "last_name": "LIPSCOMB",
            "middle_name": "S.",
            "prefix": "DR.",
            "credential": "M. D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.