Individual provider Active NPI

Maxwell Ray Martice Lippman, D.C.

  • Chiropractor
  • Danville, CA
National Provider Identifier
1295003283
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31598 Issued in CA
Practice address
4165 Blackhawk Plaza Cir Ste 250
Danville, CA 94506-4670
Phone
(510) 289-4020
NPI assigned
Dec 6, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC31598 CA Primary

Addresses

Primary practice location

4165 Blackhawk Plaza Cir Ste 250
Danville, CA 94506-4670

Mailing address

4165 Blackhawk Plaza Cir Ste 250
Danville, CA 94506-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305000545 CA Practitioner - Chiropractic 6305076720 Practice locations: Danville, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4145 Blackhawk Plaza Cir
Suite 101
Danville, CA 94506-4698
Phone (925) 964-9189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC31598CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1295003283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR STE 250",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 BLACKHAWK PLAZA CIR STE 250",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064670",
            "telephone_number": "510-289-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPMAN",
        "first_name": "MAXWELL",
        "middle_name": "RAY MARTICE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.