Organization Active NPI

Trevor Tippets DPM LLC

  • Primary Podiatric Medicine Podiatrist
  • Salem, OR
National Provider Identifier
1124661517
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
TREVOR TIPPETS DPM LLC
Practice address
1750 13TH St SE
Salem, OR 97302-2542
Phone
(503) 588-8188
Fax
(503) 588-0884
NPI assigned
Oct 18, 2019
Organization subpart
Yes
Parent organization
TREVOR TIPPETS DPM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Trevor W Tippets, DPMNPI 1477931244
Title
Owner
Phone
(503) 588-8188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X Primary

Addresses

Primary practice location

1750 13TH St SE
Salem, OR 97302-2542

Mailing address

1750 13TH St SE
Salem, OR 97302-2542
Phone (503) 588-8188

Other names 1

  • Cascade Foot Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200323002609 OR Part B Supplier - Clinic/Group Practice 8123456233 Receives reassigned benefits from 6 practitioners
Practice locations: Salem, OR

National Provider Directory

National Provider Directory
Part of
Trevor Tippets DPM LLC

Locations

540 S Main St
Mount Angel, OR 97362
Phone (503) 845-2736

3474 Liberty Rd S
Salem, OR 97302
Phone (503) 588-8188

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1124661517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022542",
            "telephone_number": "503-588-8188",
            "fax_number": "503-588-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022542",
            "telephone_number": "503-588-8188",
            "fax_number": "503-588-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREVOR TIPPETS DPM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TREVOR TIPPETS DPM LLC",
        "enumeration_date": "2019-10-18",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "TIPPETS",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-588-8188",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Foot Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cascade Foot Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.