Individual provider Active NPI

Stephen Lavon Gipson, MD

  • Pain Medicine Physician
  • Memphis, TN
National Provider Identifier
1205911518
Registry record updated Jan 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
0000014982 Issued in TN
Practice address
6005 Park Ave
Suite 400
Memphis, TN 38119-5215
Phone
(901) 767-9500
Fax
(907) 767-7324
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X MD14982 TN
Pain Medicine Physician 208VP0000X 0000014982 TN Primary

Addresses

Primary practice location

6005 Park Ave
Suite 400
Memphis, TN 38119-5215

Mailing address

6005 Park Ave
Suite 400
Memphis, TN 38119-5215
Phone (901) 767-9500

Other identifiers 3

IdentifierTypeStateIssuer
125345900OtherTNUS DEPT OF LABOR
4226549OtherAETNA
40796OtherTNBLUE CROSS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615001587 TN Practitioner - Pain ManagementPractitioner - Interventional Pain Management 4587647938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6005 Park Ave
Memphis, TN 38119-5214
Phone (901) 767-9500

Hospital & facility affiliations

  • St Francis Hospital Hospital, Memphis, TN, CCN 440183

Merit-based Incentive Payment System (MIPS)

Final score
26.65 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
88.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue77
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD14982TNMDPain Medicine (Anesthesiology) Physician
0000014982TNMDPain Medicine Physician
14982TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spine Specality Center PLLC PastSince Aug 14, 2003 Accepting new patients

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484006400000",
    "number": "1205911518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195215",
            "telephone_number": "901-767-9500",
            "fax_number": "907-767-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6005 PARK AVE",
            "address_2": "SUITE 400",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195215",
            "telephone_number": "901-767-9500",
            "fax_number": "907-767-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPSON",
        "first_name": "STEPHEN",
        "middle_name": "LAVON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2017-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TN",
            "license": "MD14982",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "TN",
            "license": "0000014982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "125345900",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4226549",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF TN",
            "identifier": "40796",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.