Individual provider Active NPI

Tiffany Dawn Lipscomb, AANP, APRN, NP-C

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1417622747
Registry record updated May 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
204971 Issued in OK
Practice address
2903 W Britton Rd
Oklahoma City, OK 73120-4433
Phone
(405) 849-4650
NPI assigned
Aug 10, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 204971 OK Primary

Addresses

Primary practice location

2903 W Britton Rd
Oklahoma City, OK 73120-4433

Mailing address

1101 Juno Cir
Edmond, OK 73003-6064
Phone (405) 550-9426

Other practice location 1

1101 Juno Cir
Edmond, OK 73003-6064
Phone (405) 550-9426

Other practice location 2

14101 N Eastern Ave Ste B
Edmond, OK 73013-5860
Phone (405) 237-5698

Other identifiers 1

IdentifierTypeStateIssuer
204971OtherOKBOARD OF NURSING

Other names 1

  • Tiffany Dawn Rightmire Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Edmond Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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 1

Enrollment IDStateProvider typePAC IDDetails
I20211123000279 OK Practitioner - Nurse Practitioner 9436548989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icare Center LLCGroup PAC ID 0840555777, 28 clinicians

Practice addresses (Care Compare)

21001 SE 29TH St
Harrah, OK 73045-6591
Phone (405) 391-5526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
204971OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icare Center LLC CurrentSince Dec 3, 2021 Accepting new patients

Locations

404 W Main St
Davis, OK 73030
Phone (405) 391-5526

21001 SE 29th St
Harrah, OK 73045
Phone (405) 391-5526

2903 W Britton Rd
Oklahoma City, OK 73120
Phone (405) 755-8028

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1628553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652918400000",
    "number": "1417622747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 JUNO CIR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730036064",
            "telephone_number": "405-550-9426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 W BRITTON RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204433",
            "telephone_number": "405-849-4650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Juno Cir",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730036064",
            "country_code": "US",
            "telephone_number": "405-550-9426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14101 N Eastern Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730135860",
            "country_code": "US",
            "telephone_number": "405-237-5698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIPSCOMB",
        "first_name": "TIFFANY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "AANP, APRN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-10",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "204971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSING",
            "identifier": "204971",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Edmond",
            "affiliation": "N",
            "endpointDescription": "beginning",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Edmond",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Edmond",
            "address_1": "1101 Juno Cir",
            "city": "Edmond",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730036064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "RIGHTMIRE",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.