Ken Lippincott, M.D., P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

09148 Issued in MS

Legal business name

KEN LIPPINCOTT, M.D., P.A.

Practice address

4428 South Eason Boulevard
Suite a
Tupelo, MS 38801-6506

Phone

(662) 844-3739

Fax

(662) 844-3728

NPI assigned

Jul 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles Kenneth LippincottNPI 1376572123

Title

Owner

Phone

(662) 844-3739

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 2

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

• Charles Kenneth Lippincott

  • Psychiatry Physician
  • Tupelo, MS
  • NPI 1376572123
  Medicare reassignment NPD Authorized official
• Lisa Theresa Lippincott, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Oxford, MS
  • NPI 1750416905
  Medicare reassignment NPD

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1386673036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4428 SOUTH EASON BOULEVARD",
            "address_2": "SUITE A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016506",
            "telephone_number": "662-844-3739",
            "fax_number": "662-844-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4428 SOUTH EASON BOULEVARD",
            "address_2": "SUITE A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016506",
            "telephone_number": "662-844-3739",
            "fax_number": "662-844-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEN LIPPINCOTT, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "LIPPINCOTT",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-844-3739",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "09148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016260",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG6420",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thomas N. Kellum, DDS
• Kimberly Ann Kelly, L.P.C
• Morgan Kelly
• Rhonda S Kelly, CRNA
• Brittney Danielle Kelton, FNP-C
• Holly J Kendrick, NP
• Stephanie Nellene Kendrick, DO
• Bethany Kennedy, NCC
• Blake Austin Kennedy, FNP-C
• Elizabeth Kennedy

• Psychiatry Physician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.