Individual provider Active NPI

Michael Lipscomb

  • Emergency Medicine Physician
  • Roswell, GA
National Provider Identifier
1124128376
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
49463 Issued in GA
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

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
000889721AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20071004000285 GA Practitioner - Emergency Medicine 3971560160 Reassigns benefits to 2 organizations
I20150625002369 SC Practitioner - Emergency Medicine 3971560160 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
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

LicenseStateTypeSpecialty
37921SCMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
49463GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Fulton Emergency Physicians, LLC Emergency Medicine CurrentSince Oct 1, 2007 Accepting new patients
Daniel Island Emergency Physicians, LLC Emergency Medicine CurrentSince Jun 15, 2026 Accepting new patients
Georgia Emergency Group, LLC Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients
North Carolina Emergency Physicians, PLLC Emergency Medicine PastSince Feb 9, 2020 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

  • FHIR API: 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.

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

Verify at the official NPI Registry.