Individual provider Active NPI

Jeffrey H.J. Nipper, MD

  • Orthopaedic Surgery Physician
  • Maple Grove, MN
National Provider Identifier
1457314734
Registry record updated Dec 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
31558 Issued in MN
Practice address
9325 Upland LN N Ste 205
Maple Grove, MN 55369-4474
Phone
(763) 416-0676
Fax
(763) 416-0476
NPI assigned
Apr 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 31558 MN Primary

Addresses

Primary practice location

9325 Upland LN N Ste 205
Maple Grove, MN 55369-4474

Mailing address

9325 Upland LN N Ste 205
Maple Grove, MN 55369-4474
Phone (763) 416-0676

Other identifiers 1

IdentifierTypeStateIssuer
1457314734MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20101023000253 MN Practitioner - Orthopedic Surgery 3375736259

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31558MNMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1457314734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N STE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694474",
            "telephone_number": "763-416-0676",
            "fax_number": "763-416-0476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9325 UPLAND LN N STE 205",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694474",
            "telephone_number": "763-416-0676",
            "fax_number": "763-416-0476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIPPER",
        "first_name": "JEFFREY",
        "middle_name": "H.J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "31558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457314734",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

Verify at the official NPI Registry.