Individual provider Active NPI

Adam L. Sipe, MD

  • Diagnostic Radiology Physician
  • Fayetteville, AR
National Provider Identifier
1447512868
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
E-11126 Issued in AR
Practice address
1100 N College Ave
Fayetteville, AR 72703-1944
Phone
(794) 443-4301
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2017006926 MO
Diagnostic Radiology Physician 2085R0202X E-11126 AR Primary

Addresses

Primary practice location

1100 N College Ave
Fayetteville, AR 72703-1944

Mailing address

1100 N College Ave
Fayetteville, AR 72703-1944
Phone (479) 443-4301

Other practice location 1

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone (314) 362-7200

Other practice location 2

500 S University Ave Ste 101
Little Rock, AR 72205
Phone (501) 664-3914

Other practice location 3

7900 Lees Summit Rd
Kansas City, MO 64139-1236
Phone (816) 404-0690

Other practice location 4

2301 Holmes St
Kansas City, MO 64108-2640
Phone (816) 404-0690

Other identifiers 3

IdentifierTypeStateIssuer
ENROLLEDMedicaidIL
223065001MedicaidAR
200041366MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017006926MOMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1447512868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "479-443-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 N COLLEGE AVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031944",
            "telephone_number": "794-443-4301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 S Kingshighway Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631101016",
            "country_code": "US",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 S University Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "72205",
            "country_code": "US",
            "telephone_number": "501-664-3914",
            "fax_number": "501-664-5246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7900 Lees Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641391236",
            "country_code": "US",
            "telephone_number": "816-404-0690",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 Holmes St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641082640",
            "country_code": "US",
            "telephone_number": "816-404-0690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIPE",
        "first_name": "ADAM",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2017006926",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AR",
            "license": "E-11126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223065001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200041366",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.