Active NPI
Robert Sander Hipp, MD
- Surgery Physician
- Olympia, WA
National Provider Identifier
1063454155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 12773
- Practice address
- 3920 Capitol Mall Dr
Suite 302
Olympia, WA 98502 - Phone
- (360) 754-3507
- Fax
- (360) 236-1457
- NPI assigned
- Jun 12, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 12773 | WA | Primary |
Addresses
Primary practice location
3920 Capitol Mall Dr
Suite 302
Olympia, WA 98502
Mailing address
P.O. Box 9532
Tacoma, WA 98409
Phone (360) 491-5999
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115567 | Other | WA | LABOR & INDUSTRY |
| 8198020 | Medicaid | WA |
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12773 | WA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204848000000",
"number": "1063454155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 9532",
"city": "TACOMA",
"state": "WA",
"postal_code": "98409",
"telephone_number": "360-491-5999",
"fax_number": "360-491-5946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 CAPITOL MALL DR",
"address_2": "SUITE 302",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "98502",
"telephone_number": "360-754-3507",
"fax_number": "360-236-1457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIPP",
"first_name": "ROBERT",
"middle_name": "SANDER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2008-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "12773",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "115567",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8198020",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.