Individual provider Active NPI

Reagan Earl Tipton Jr., DO

  • Family Medicine Physician
  • Waco, TX
National Provider Identifier
1487622544
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H8462 Issued in TX
Practice address
2304 Marketplace Dr
Waco, TX 76711-2467
Phone
(254) 202-7300
Fax
(254) 202-7350
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H8462 TX Primary

Addresses

Primary practice location

2304 Marketplace Dr
Waco, TX 76711-2467

Mailing address

PO Box 848476
Dallas, TX 75284-8476
Phone (254) 202-4655

Other practice location 1

3401 East Main St
Gatesville, TX 76528
Phone (254) 865-2166

Other identifiers 2

IdentifierTypeStateIssuer
8H3675OtherTXBCBS
117747904MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rtipton16243@direct.sw.org Direct
Direct Messaging Address rtipton16243@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20050107000640 TX Practitioner - Family Practice 4082662846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hillcrest Family Health CenterGroup PAC ID 4183612278, 62 clinicians

Practice addresses (Care Compare)

1001 Hewitt Dr
Waco, TX 76712-8486
Phone (254) 202-7800

2201 Macarthur Dr
Waco, TX 76708-3161
Phone (254) 202-4360

2304 Marketplace Dr
Waco, TX 76711-2467
Phone (254) 202-7300

7300 Bosque Blvd
Waco, TX 76710-4023
Phone (254) 202-7700

851 N Loop
340 B S and W H Clinic Bellmead
Waco, TX 76705-2592
Phone (254) 202-7500

Hospital & facility affiliations

  • Accentcare Home Health of Waco Home health agency, Waco, TX, CCN 679200
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101
  • Coryell Memorial Hospital Hospital, Gatesville, TX, CCN 451379
  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054
  • Ascension Providence Hospital, Waco, TX, CCN 450042

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H8462TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hillcrest Family Health Center Family Medicine CurrentSince Jan 10, 2005 Accepting new patients
Soheil Hekmat, MD, Inc. Past Accepting new patients

Locations

3401 E Main St
Gatesville, TX 76528

851 N Loop 340
#B
Waco, TX 76705
Phone (254) 202-7500

50 Hillcrest Medical Blvd
Ste 104
Waco, TX 76712
Phone (254) 202-7300

2304 Marketplace Dr
Waco, TX 76711
Phone (254) 202-2000

Interoperability endpoints

  • Direct secure messaging: rtipton16243@direct.sw.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1487622544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848476",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848476",
            "telephone_number": "254-202-4655",
            "fax_number": "254-202-4697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 MARKETPLACE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767112467",
            "telephone_number": "254-202-7300",
            "fax_number": "254-202-7350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 East Main St",
            "address_purpose": "LOCATION",
            "city": "Gatesville",
            "state": "TX",
            "postal_code": "76528",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-865-8766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "REAGAN",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H8462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8H3675",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117747904",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtipton16243@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2304 Marketplace Dr",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767112467",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtipton16243@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2304 Marketplace Dr",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767112467",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.