Wayne E Tipps, DDS

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2083 Issued in TN

Practice address

6015 Shallowford Road
Chattanooga, TN 37421-1688

Phone

(423) 893-3333

Fax

(423) 954-3054

NPI assigned

May 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2020 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Professional Medical Properties, LLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Chattanooga, TN
  • NPI 1700970407
  NPD (past) Authorized official
• Charles Dunlap, DDS

  • Specialist
  • Fort Oglethorpe, GA
  • NPI 1225150964
  NPD (past)

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

{
    "created_epoch": "1116979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1154324804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-893-3333",
            "fax_number": "423-954-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 SHALLOWFORD ROAD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211688",
            "telephone_number": "423-893-3333",
            "fax_number": "423-954-3054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPS",
        "first_name": "WAYNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-25",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TN",
            "license": "2083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "4665595",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTN PROVIDER NUMBER",
            "identifier": "2004791",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3215429",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mariah Tinsley, LCSW
• Randy Tinsley
• Sara Tinter, MS CCC-SLP
• Jeffrey E Tipps, M.D.
• Steven P Tipps, DDS
• Matthew Tipton
• Titan Medical Supply, Inc.
• Christy Dawn Tittsworth, APN
• TK Home Karing Service
• TLC Medical Oxygen & Hospital Equipment, Inc.

• Oral & Maxillofacial Surgery (D.M.D.) in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.