Active NPI
Channing Lipson, M.D.
- Psychiatry Physician
- West Bloomfield, MI
National Provider Identifier
1194063057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301019122
- Practice address
- 2095 Bordeaux St
West Bloomfield, MI 48323-3012 - Phone
- (248) 737-1984
- NPI assigned
- Jan 27, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301019122 | MI | Primary |
Addresses
Primary practice location
2095 Bordeaux St
West Bloomfield, MI 48323-3012
Mailing address
2095 Bordeaux St
West Bloomfield, MI 48323-3012
Phone (248) 737-1984
Medicare participation
Medicare enrollment files- 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
- Opted out of Medicare
- Yes, effective Jun 15, 2016 through Jun 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301019122 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359244800000",
"number": "1194063057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2095 BORDEAUX ST",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483233012",
"telephone_number": "248-737-1984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2095 BORDEAUX ST",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483233012",
"telephone_number": "248-737-1984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPSON",
"first_name": "CHANNING",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-27",
"last_updated": "2013-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301019122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2013; 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.