Individual provider Active NPI

Katelyn Lippert

  • Emergency Medicine Physician
  • Dayton, OH
National Provider Identifier
1063807238
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.131068 Issued in OH
Practice address
1 Wyoming St
Che 7TH Floor
Dayton, OH 45409-2722
Phone
(937) 208-2485
NPI assigned
Apr 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35.131068 OH Primary

Addresses

Primary practice location

1 Wyoming St
Che 7TH Floor
Dayton, OH 45409-2722

Mailing address

88 MDG/SGHJ
4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433
Phone (937) 257-9655

Other practice location 1

4881 Sugar Maple Dr
Dayton, OH 45433
Phone (937) 257-9655

Other practice location 2

600 W Main St
Troy, OH 45373-3384
Phone (937) 980-7010

Other practice location 3

1 Kettering Way
Piqua, OH 45356-4109
Phone (937) 916-2625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201027001686 OH Practitioner - Emergency Medicine 2668786450 Reassigns benefits to 3 organizations
I20250213001748 NV Practitioner - Emergency Medicine 2668786450 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Kentucky College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

600 W Main St
Troy, OH 45373-2928
Phone (937) 980-7010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.131068OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Specialists, Inc Emergency Medicine CurrentSince Oct 22, 2020 Accepting new patients
Ohio Emergency Professionals Inc Emergency Medicine CurrentSince Feb 25, 2022 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Jan 13, 2025 Accepting new patients
Shadow Emergency Physicians PLLC Emergency Medicine CurrentSince Jan 13, 2025 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Current Accepting new patients
Emergency Medicine Specialists, Inc Emergency Medicine CurrentSince Oct 22, 2020 Accepting new patients
Miami Valley Emergency Specialists, LLC Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
Emergency Medicine Specialists Inc Emergency Medicine Past Accepting new patients

Locations

620 Shadow Ln
Las Vegas, NV 89106
Phone (702) 388-4506

2400 Lakeview Dr
#150
Beavercreek, OH 45431

1 Wyoming St
Dayton, OH 45409
Phone (937) 208-2636

1 Wyoming St
Fl 7
Dayton, OH 45409
Phone (937) 208-2485

630 Eaton Ave
Hamilton, OH 45013
Phone (513) 867-2000

3535 Southern Blvd
Kettering, OH 45429
Phone (937) 298-1221

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

300 Austin West Blvd
Miamisburg, OH 45342
Phone (937) 388-7911

4000 Miamisburg Centerville Rd
Miamisburg, OH 45342
Phone (937) 384-8791

1 Kettering Way
Piqua, OH 45356
Phone (937) 916-2615

600 W Main St
Troy, OH 45373
Phone (937) 395-6665

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1063807238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 MDG/SGHJ",
            "address_2": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "45433",
            "telephone_number": "937-257-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WYOMING ST",
            "address_2": "CHE 7TH FLOOR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092722",
            "telephone_number": "937-208-2485"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4881 Sugar Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "45433",
            "country_code": "US",
            "telephone_number": "937-257-9655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "600 W Main St",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453733384",
            "country_code": "US",
            "telephone_number": "937-980-7010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Kettering Way",
            "address_purpose": "LOCATION",
            "city": "Piqua",
            "state": "OH",
            "postal_code": "453564109",
            "country_code": "US",
            "telephone_number": "937-916-2625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPPERT",
        "first_name": "KATELYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-03",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.131068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.