Joseph W Ippolito Jr MD PLLC

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

M7008 Issued in ID

Legal business name

JOSEPH W IPPOLITO JR MD PLLC

Practice address

526 Shoup Ave W
Suite F
Twin Falls, ID 83301-4591

Phone

(208) 736-7620

Fax

(208) 735-9537

NPI assigned

Mar 3, 2009

Last updated

Aug 29, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph W Ippolito Jr., MDNPI 1306862792

Title

Medical Doctor/Owner

Phone

(208) 736-7620

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DDCECA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph W Ippolito Jr., M.D.

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1306862792
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346198400000",
    "number": "1154561116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 SHOUP AVE W",
            "address_2": "SUITE F",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014591",
            "telephone_number": "208-736-7620",
            "fax_number": "208-735-9537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 SHOUP AVE W",
            "address_2": "SUITE F",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833014591",
            "telephone_number": "208-736-7620",
            "fax_number": "208-735-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH W IPPOLITO JR MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2012-08-29",
        "status": "A",
        "authorized_official_last_name": "IPPOLITO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEDICAL DOCTOR/OWNER",
        "authorized_official_telephone_number": "208-736-7620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "ID",
            "license": "M7008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF IDAHO",
            "identifier": "000010001696",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "DY066",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003755600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory P Jones, M.D.
• Melissa Lynn Jones, M.A. CCC-SLP
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• Steven Jones, LSW
• Jennifer Speicher Jorgensen, DNP
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• Jana Kay Juker, LPN
• Julie a Schwerman, LLC
• Julie's Premier Home Care LLC
• Michael B Jurgensmeier, COUI

• Preferred Provider Organization in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Preferred Provider Organization in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.