Mary M Tippin, N.P.

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

094007047 Issued in OR

Practice address

1475 Mt. Hood Avenue
Woodburn, OR 97071

Phone

(971) 983-5252

Fax

(971) 983-5253

NPI assigned

Nov 13, 2006

Last updated

Aug 14, 2013By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Silverton Health

  dba Legacy Silverton Medical Center

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment NPD
• Silverton Health

  • Clinic/Center
  • Woodburn, OR
  • NPI 1215347109
  NPD
• Silverton Health

  • Family Medicine Physician
  • Silverton, OR
  • NPI 1306191044
  NPD
• Silverton Health

  dba Legacy Molalla Family Medicine

  • Clinic/Center
  • Molalla, OR
  • NPI 1861116055
  NPD

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376438400000",
    "number": "1316018864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 MT. HOOD AVENUE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "971-983-5252",
            "fax_number": "971-983-5253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 MT. HOOD AVENUE",
            "city": "WOODBURN",
            "state": "OR",
            "postal_code": "97071",
            "telephone_number": "971-983-5252",
            "fax_number": "971-983-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPIN",
        "first_name": "MARY",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OR",
            "license": "094007047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071514",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Telecare Mental Health Services of Oregon, Inc (Telecare Recovery Center at Woodburn)
• Telecare Recovery Services
• Marisol Tello Vasquez
• Matthew Wayne Theeler Sr., CADC1
• Sarah Elizabeth Thomas, PHARM.D.
• Elizabeth Torres, RN, BSN
• Julie Tran
• Victor Tran
• Travis Buckmaster L.Ac.,P.C.
• Tana Nicola Treffers, CMHC-INTERN

• Women's Health Nurse Practitioner in Woodburn, OR
• Providers in Woodburn, OR by specialty
• Women's Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.