Jay I Lipoff, MD

Primary specialty

SpecialistTaxonomy code 174400000X

License

036099740 Issued in IL

Practice address

8316 Express Dr
Marion, IL 62959-5895

Phone

(618) 998-8447

Fax

(618) 998-9787

NPI assigned

Aug 9, 2005

Reactivated

Apr 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Marion Diagnostic Center, LLC

  • Multi-Specialty Clinic/Center
  • Marion, IL
  • NPI 1366543084
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1467453761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8316 EXPRESS DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595895",
            "telephone_number": "618-998-8447",
            "fax_number": "618-998-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 EXPRESS DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595895",
            "telephone_number": "618-998-8447",
            "fax_number": "618-998-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPOFF",
        "first_name": "JAY",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2009-12-22",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "036099740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036099740I",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Life Home Health Care Inc. of Southern Illinois
• Life Line Emergency Medical Response Service Corp
• Joseph Lingle, RPH
• Lucille Grace Lingle, RN
• Meth Linwong, M.D.
• Denise Little, RN
• Xingtong Liu
• Monette R Logue, BSW
• Kathy Amanda Long, ARNP-BC
• Mary Elizabeth Long, RN

• Specialist in Marion, IL
• Providers in Marion, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; 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.