Active NPI
Lucas Andrew Tipton, DMD
- Dentist
- Elizabethton, TN
National Provider Identifier
1184358053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 11996
- Practice address
- 1975 W Elk Ave Ste 2
Elizabethton, TN 37643-3787 - Phone
- (423) 543-2755
- NPI assigned
- Jul 14, 2022
- Last updated
- Jul 14, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 11996 | TN | Primary |
Addresses
Primary practice location
1975 W Elk Ave Ste 2
Elizabethton, TN 37643-3787
Mailing address
1975 W Elk Ave Ste 2
Elizabethton, TN 37643-3787
Phone (423) 543-2755
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11996 | TN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657756800000",
"number": "1184358053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1975 W ELK AVE STE 2",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376433787",
"telephone_number": "423-543-2755"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 W ELK AVE STE 2",
"city": "ELIZABETHTON",
"state": "TN",
"postal_code": "376433787",
"telephone_number": "423-543-2755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPTON",
"first_name": "LUCAS",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-14",
"last_updated": "2022-07-14",
"certification_date": "2022-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "11996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabethton, TN
- Thrive Life Advancement Ministries Inc
- John W Thurman, PH.D
- Cheryl Ann Timbs, LCSW
- Timothy Street (T L C Medical Transportation)
- Carly Morgan Tipton, DMD
- Laurie E Trosin, MD
- Jessica B Tuberty, M.D.
- Union Prescription of Elizabethton Tennessee Inc (Union Prescription Shop)
- Valley Ridge Emergency Physicians, LLP
- Cassandra Racheal Vanover, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.