Active NPI
Michael Lipscomb
- Emergency Medicine Physician
- Roswell, GA
National Provider Identifier
1124128376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 49463
- Practice address
- 3000 Hospital Blvd
Roswell, GA 30076-4915 - Phone
- (770) 751-2567
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 49463 | GA | Primary |
Addresses
Primary practice location
3000 Hospital Blvd
Roswell, GA 30076-4915
Mailing address
5665 New Northside Dr NW
Atlanta, GA 30328-5831
Phone (770) 874-5400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000889721A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA, SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37921 | SC | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| 49463 | GA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Fulton Emergency Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| Daniel Island Emergency Physicians, LLC | Emergency Medicine | Current | Accepting new patients |
| Georgia Emergency Group, LLC | Emergency Medicine | Current | Accepting new patients |
| North Carolina Emergency Physicians, PLLC | Emergency Medicine | Past | Accepting new patients |
Locations
601 S 8th St
Griffin, GA 30224
Phone (770) 228-2721
1050 McDonough Rd
Jackson, GA 30233
Phone (770) 775-7861
3000 Hospital Blvd
Roswell, GA 30076
Phone (770) 751-2500
Interoperability endpoints
- https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1124128376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5665 NEW NORTHSIDE DR NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303285831",
"telephone_number": "770-874-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 HOSPITAL BLVD",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300764915",
"telephone_number": "770-751-2567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPSCOMB",
"first_name": "MICHAEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "49463",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000889721A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.