Rory E Tippit, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00225700 Issued in NJ

Practice address

6749 E 16TH St
21St CST WMD
Fort Dix, NJ 08640-5709

Phone

(210) 383-1934

NPI assigned

Dec 22, 2009

Last updated

Dec 22, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1073842068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6749 E 16TH ST",
            "address_2": "21ST CST WMD",
            "city": "FORT DIX",
            "state": "NJ",
            "postal_code": "086405709",
            "telephone_number": "210-383-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6749 E 16TH ST",
            "address_2": "21ST CST WMD",
            "city": "FORT DIX",
            "state": "NJ",
            "postal_code": "086405709",
            "telephone_number": "210-383-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPIT",
        "first_name": "RORY",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00225700",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Nicole Simpson II
• Jonathan Sirkin, MD
• SRC Pending Consult Management
• Christine Lee Stinner, RN,BSN
• Melissa Sherona Thompson, PHARM.D
• Walson Medical Support Element
• Scott J Winters, FNP
• Tyler Wyatt, DVM
• Anna Maria Zucker, APN-C, MSN

• Physician Assistant in Fort Dix, NJ
• Providers in Fort Dix, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.