Individual provider Active NPI

Jessica Ann Lipp, NP

  • Family Nurse Practitioner
  • Lebanon, IN
National Provider Identifier
1144713934
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008136A Issued in IN
Practice address
2705 N Lebanon St Ste 405
Lebanon, IN 46052-8621
Phone
(765) 485-8444
Fax
(765) 485-8439
NPI assigned
Jun 7, 2018
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71008136A IN Primary
Registered Nurse 163W00000X 28134497A IN

Addresses

Primary practice location

2705 N Lebanon St Ste 405
Lebanon, IN 46052-8621

Mailing address

2605 N Lebanon St
Lebanon, IN 46052-1476

Other identifiers 1

IdentifierTypeStateIssuer
300016998MedicaidIN

Other names 1

  • Jessica Ann Kwasigroh Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlipp@withamdirect.org Health Information Exchange (HIE) Witham Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824001329 IN Practitioner - Nurse Practitioner 5092064097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

2485 E Wabash
Frankfort, IN 46041-9400
Phone (765) 659-7400

2485 E Wabash St
Suite 110
Frankfort, IN 46041-9400
Phone (765) 659-7400

2505 N Lebanon St
Lebanon, IN 46052-8613
Phone (765) 485-8830

2705 N Lebanon St
Lebanon, IN 46052-8621

6085 Heartland Dr
Zionsville, IN 46077-4433

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71008136AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Witham Memorial Hospital CurrentSince Jul 18, 2018 Accepting new patients
Witham Memorial Hospital CurrentSince Jul 18, 2018 Accepting new patients

Locations

2505 N Lebanon St
Ste 208
Lebanon, IN 46052
Phone (765) 483-7360

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

2705 N Lebanon St
Ste 305
Lebanon, IN 46052
Phone (765) 485-8677

2705 N Lebanon St
Ste 405
Lebanon, IN 46052
Phone (765) 485-8444

6085 Heartland Dr
Ste 204
Zionsville, IN 46077
Phone (317) 768-2134

Interoperability endpoints

  • Direct secure messaging: jlipp@withamdirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1144713934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 N LEBANON ST STE 405",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460528621",
            "telephone_number": "765-485-8444",
            "fax_number": "765-485-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPP",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-07",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008136A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28134497A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300016998",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlipp@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2705 N Lebanon St Ste 405",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460528621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KWASIGROH",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, IN

Sources for this page

Verify at the official NPI Registry.