Bradi Michael Peter Kipper, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

002217 Issued in IA

Practice address

2300 53Rd Ave
Suite 100
Bettendorf, IA 52722-7564

Phone

(563) 322-0971

Fax

(563) 324-0615

NPI assigned

Aug 17, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA, IL2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ora Orthopedics PC

  • Orthopaedic Surgery Physician
  • Moline, IL
  • NPI 1962481861

  IL

  Medicare reassignment
• Ora Orthopedics PC

  • Physical Therapist
  • Rock Island, IL
  • NPI 1508645680
  NPD
• Ora Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Durant, IA
  • NPI 1639159700
  NPD (past)

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1184904567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 53RD AVE",
            "address_2": "SUITE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227564",
            "telephone_number": "563-322-0971",
            "fax_number": "563-324-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 53RD AVE",
            "address_2": "SUITE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227564",
            "telephone_number": "563-322-0971",
            "fax_number": "563-324-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIPPER",
        "first_name": "BRADI",
        "middle_name": "MICHAEL PETER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002217",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085004237",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "578210014",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gun Hee Kim
• Kimball & Beecher Group LLC
• James Dougherty King, DO
• Kelly Lee Kingma, D.D.S.
• Lisa Lynn Kinney, L.P.C.
• Richard M Kishiue, MD
• Kivisto Counseling and Therapy LLC
• Sarah Kivisto, LISW
• Joseph David Klein, D.V.M.
• John J Klosak, M.D.

• Physician Assistant in Bettendorf, IA
• Providers in Bettendorf, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.