Tippin Family Medicine Clinic, P. a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

TIPPIN FAMILY MEDICINE CLINIC, P. A.

Practice address

804 Danark Circle
Danville, AR 72833-0220

Phone

(479) 495-7300

Fax

(479) 495-7981

NPI assigned

Aug 14, 2006

Organization subpart

No

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

Authorized official

Name

Michelle Jean Banning-Tippin, M.D.

Title

Office Manager/Physcian

Phone

(479) 495-7300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Jean Banning, M.D.

  • Family Medicine Physician
  • Danville, AR
  • NPI 1790753929
  Medicare reassignment Care Compare group NPD
• Philip Brian Tippin, M.D.

  • Family Medicine Physician
  • Danville, AR
  • NPI 1760451876
  Medicare reassignment Care Compare group NPD
• Nicki J Foxx, CRNA

  • Certified Registered Nurse Anesthetist
  • Valliant, OK
  • NPI 1457380750
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1295748960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 DANARK CIRCLE",
            "address_2": "P O BOX 220",
            "city": "DANVILLE",
            "state": "AR",
            "postal_code": "728330220",
            "telephone_number": "479-495-7300",
            "fax_number": "479-495-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 DANARK CIRCLE",
            "city": "DANVILLE",
            "state": "AR",
            "postal_code": "728330220",
            "telephone_number": "479-495-7300",
            "fax_number": "479-495-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIPPIN FAMILY MEDICINE CLINIC, P. A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "BANNING-TIPPIN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER/PHYSCIAN",
        "authorized_official_telephone_number": "479-495-7300",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121819002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Super D Drugs Acquisition Co
• Super RX Medical Supply
• Amanda J. Swint, LPTA
• Natalie Danielle Tarte
• Thomas John Tinnesz, M.D.
• Philip Brian Tippin, M.D.
• Valerie Traenkenschuh, SLP
• Marirose E Ussery, OTRL
• Misty Vick
• Walgreen Co

• Family Medicine Physician in Danville, AR
• Providers in Danville, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.