Active NPI
Jodi Lynn Tippett, APRN BC
- Psychiatric/Mental Health Nurse Practitioner
- Waltham, MA
National Provider Identifier
1083797302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 237497
- Practice address
- 169 Elm St
Waltham, MA 02453-5356 - Phone
- (781) 894-8440
- Fax
- (781) 894-1202
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 237497 | MA | Primary |
Addresses
Primary practice location
169 Elm St
Waltham, MA 02453-5356
Mailing address
169 Elm St
Waltham, MA 02453-5356
Phone (781) 894-8440
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1303287 | Other | MA | MBHP |
| 1303287 | Medicaid | MA | |
| M18633 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 237497 | MA | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Edinburg Center Inc | Psychiatric/Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083797302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ELM ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024535356",
"telephone_number": "781-894-8440",
"fax_number": "781-894-1202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ELM ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024535356",
"telephone_number": "781-894-8440",
"fax_number": "781-894-1202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPPETT",
"first_name": "JODI",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "APRN BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "MA",
"license": "237497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBHP",
"identifier": "1303287",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1303287",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "M18633",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.