John Douglas Ipsen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32307-20 Issued in WI

Practice address

53585 Nokomis Rd
Ashland, WI 54806-4272

Phone

(715) 682-7133

Fax

(715) 685-7857

NPI assigned

May 13, 2006

Last updated

Jul 14, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bad River Band of Lake Superior Tribe of Chippewa Indians Wis

  • Federally Qualified Health Center (FQHC)
  • Ashland, WI
  • NPI 1699701375

  TX

  Medicare reassignment NPD
• Bad River Band of Lake Superior Tribe of Chippewa Indians Wis.

  dba Bad River Clinic Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Ashland, WI
  • NPI 1780702829
  NPD

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499990400000",
    "number": "1073564126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53585 NOKOMIS RD",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548064272",
            "telephone_number": "715-682-7133",
            "fax_number": "715-685-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53585 NOKOMIS RD",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548064272",
            "telephone_number": "715-682-7133",
            "fax_number": "715-685-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPSEN",
        "first_name": "JOHN",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-13",
        "last_updated": "2017-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "37146",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "32307-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "080005095",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220313800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Hyde
• Kimberly Ann Hyopponen, D.D.S.
• Impact Counseling Services, LLC
• Impact Counseling Services, LLC
• Amy L Innes, PHARMD.
• Bradley C Irwin, MD
• J & C Stock SC (Medicine Shoppe)
• Barry T Jacobs, DDS
• Amy Jacobson, AUD
• Michaelene Pheifer Jansen, RN, CNP

• Family Medicine Physician in Ashland, WI
• Providers in Ashland, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.