NPIMap

Individual provider Active NPI

Shane Casey Tipton, MD

  • Orthopaedic Surgery Physician
  • Concord, NC
National Provider Identifier
1073977948
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2022-00346 Issued in NC
Practice address
1090 NE Gateway CT NE
Ste 204
Concord, NC 28025-2414
Phone
(704) 403-7020
NPI assigned
Apr 7, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2022-00346 NC Primary

Addresses

Primary practice location

1090 NE Gateway CT NE
Ste 204
Concord, NC 28025-2414

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

5651 Poplar Tent Rd
Ste 200
Concord, NC 28027-7686
Phone (704) 403-7020

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address stipton1055042@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220908002468 NC Practitioner - Orthopedic Surgery 9638465271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Un of California, Irvine, College of Medicine, 2016
Medicare assignment
May accept Medicare assignment
Group practices
The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians
Comprehab, IncGroup PAC ID 2769653757, 376 clinicians
Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Practice addresses (Care Compare)

1090 NE Gateway CT NE
Suite 204
Concord, NC 28025-2423
Phone (704) 403-7020

2675 Court Dr
Gastonia, NC 28054-1478
Phone (704) 824-7800

6604 Roberta Rd
Harrisburg, NC 28075-9532
Phone (419) 221-6717

Hospital & facility affiliations

  • Gentiva Health Services/Salisb Home health agency, Kannapolis, NC, CCN 347170
  • Adoration Home Health Home health agency, Concord, NC, CCN 347126
  • Carolinas Medical Center-Northeast Hospital, Concord, NC, CCN 340001
  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
  • Stanly Regional Medical Center Hospital, Albemarle, NC, CCN 340119

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement37
Knee replacement15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Charlotte-Mecklenburg Hospital Authority Orthopaedic Surgery CurrentSince Sep 6, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Current Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Sep 6, 2022 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority Past Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

5651 Poplar Tent Rd
Ste 200
Concord, NC 28027
Phone (704) 403-2275

1085 NE Gateway Ct NE
#200A
Concord, NC 28025
Phone (704) 403-8650

1090 NE Gateway Ct NE
Ste 204
Concord, NC 28025
Phone (704) 403-7020

Interoperability endpoints

  • Direct secure messaging: stipton56064@direct.emory.org
  • Direct secure messaging: stipton1055042@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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 12

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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1073977948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 NE GATEWAY CT NE",
            "address_2": "STE 204",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252414",
            "telephone_number": "704-403-7020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5651 Poplar Tent Rd",
            "address_2": "Ste 200",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280277686",
            "country_code": "US",
            "telephone_number": "704-403-7020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "SHANE",
        "middle_name": "CASEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-07",
        "last_updated": "2024-07-15",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2022-00346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stipton1055042@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1090 NE Gateway Ct NE",
            "address_2": "Ste 204",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.