Individual provider Active NPI

Jay M Lipke, M.D.

  • Orthopaedic Surgery Physician
  • Little Rock, AR
National Provider Identifier
1083606933
Registry record updated Jan 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
R2399 Issued in AR
Practice address
800 Fair Park Blvd
Little Rock, AR 72204
Phone
(501) 604-6900
NPI assigned
Aug 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2019

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 R2399 AR Primary

Addresses

Primary practice location

800 Fair Park Blvd
Little Rock, AR 72204

Mailing address

800 Fair Park Blvd
Little Rock, AR 72204-1720
Phone (501) 978-2623

Other identifiers 1

IdentifierTypeStateIssuer
104419001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20100210000352 AR Practitioner - Orthopedic Surgery 4688575772 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R2399ARMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoarkansas, PA CurrentSince Jan 1, 2019 Accepting new patients
Orthoarkansas, PA CurrentSince Jan 1, 2019 Accepting new patients
Arkansas Health Group Past Accepting new patients
South Arkansas Orthopaedics and Sports Medicine Center PLLC Orthopaedic Surgery Past Accepting new patients

Locations

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

800 Fair Park Blvd
Little Rock, AR 72204
Phone (501) 404-8007

10301 Kanis Rd
Little Rock, AR 72205
Phone (501) 604-4151

3480 Landers Rd
North Little Rock, AR 72117
Phone (501) 955-5519

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.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1083606933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722041720",
            "telephone_number": "501-978-2623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FAIR PARK BLVD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72204",
            "telephone_number": "501-604-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPKE",
        "first_name": "JAY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AR",
            "license": "R2399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104419001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.