Elise Anne Lippincott, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

390200000X Issued in TN

Practice address

2570 NW Edenbower Blvd
Roseburg, OR 97471-6214

Phone

(541) 677-7200

NPI assigned

Apr 7, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Elise Anne Huber Other name

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elise.lippincott.1@1334.direct.athenahealth.com

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.

• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Roseburg, OR
  • NPI 1134436637
  Medicare reassignment NPD
• Centennial Medical Group East, LLC

  • Obstetrics & Gynecology Physician
  • Roseburg, OR
  • NPI 1134243249
  NPD
• Centennial Medical Group East, LLC

  • Family Medicine Physician
  • Sutherlin, OR
  • NPI 1164124111
  NPD

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1295314029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 RIVER BEND RD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974718241",
            "telephone_number": "989-350-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 NW EDENBOWER BLVD",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974716214",
            "telephone_number": "541-677-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPINCOTT",
        "first_name": "ELISE",
        "middle_name": "ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "390200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISE",
            "last_name": "HUBER",
            "middle_name": "ANNE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kenneth L Linden, MD
• Justin Kyle Lindsey, PT, DPT
• Paul R Lineback, M.S., LPC, LMHC
• Dawn Linne, LCSW
• Beth Linville
• Jordan Michael Lippincott, MD
• Mandy Liu, PHARM.D.
• Tracia Livingston
• Keila Elizabeth Lloyd
• Megan Pilar Locker

• Pediatrics Physician in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.