Individual provider Active NPI

Austen Kendehl Nelson Lipham, DO

  • Family Medicine Physician
  • Danville, VA
National Provider Identifier
1316504764
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102207162 Issued in VA
Practice address
109 Bridge St Ste 201
Danville, VA 24541-1222
Phone
(434) 799-4488
Fax
(434) 773-6977
NPI assigned
May 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0116032614 VA
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 0102207162 VA Primary

Addresses

Primary practice location

109 Bridge St Ste 201
Danville, VA 24541-1222

Mailing address

109 Bridge St Ste 201
Danville, VA 24541-1222
Phone (434) 799-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20220607002385 VA Practitioner - Family Practice 9032542642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Danville Physician Practices LLCGroup PAC ID 4688606304, 171 clinicians

Practice addresses (Care Compare)

109 Bridge St
Suite 201
Danville, VA 24541-1222
Phone (434) 799-4488

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102207162VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Danville Physician Practices LLC CurrentSince Jul 15, 2022 Accepting new patients
Greensboro Pathology, LLC Current Accepting new patients
Danville Physician Practices LLC Family Medicine CurrentSince Jul 15, 2022 Accepting new patients

Locations

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

142 S Main St
Danville, VA 24541
Phone (434) 799-2100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

Organizations & group practices 3

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 2

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": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1316504764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BRIDGE ST STE 201",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411222",
            "telephone_number": "434-799-4488",
            "fax_number": "434-773-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BRIDGE ST STE 201",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245411222",
            "telephone_number": "434-799-4488",
            "fax_number": "434-773-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPHAM",
        "first_name": "AUSTEN",
        "middle_name": "KENDEHL NELSON",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116032614",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102207162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.