Kyle Thomas Lipscomb, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-10456 Issued in NC

Practice address

633 Brookdale Dr Ste 300
Statesville, NC 28677-3471

Phone

(704) 978-4025

NPI assigned

Jan 24, 2020

Last updated

Aug 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Iredell Memorial Hospital Inc Hospital, Statesville, NC, CCN 340039

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Piedmont Healthcare, P.a.

  • Internal Medicine Physician
  • Statesville, NC
  • NPI 1912999897
  Medicare reassignment Care Compare group NPD
• Piedmont Healthcare, PA

  • Durable Medical Equipment & Medical Supplies
  • Statesville, NC
  • NPI 1639041320
  NPD

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

• Iredell Memorial Hospital, Incorporated

  • General Acute Care Hospital
  • Statesville, NC
  • NPI 1417944224
  Care Compare affiliation

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1619507027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 BROOKDALE DR STE 300",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286773471",
            "telephone_number": "704-978-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSCOMB",
        "first_name": "KYLE",
        "middle_name": "THOMAS",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-24",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifespan, Inc.
• Lindsay Spears DDS PLLC (Carolina Crossroads Dental Care)
• Kimberly Chevelle Linney, LPCA
• Dottie Linyard, CRNA
• Jennifer Joanne Lippel, MA, LCMHCA.
• Shannon Brooke Little, RN; BSN
• Chaqueenia Yvette Livingston, MA, NCC, LCMHC
• Jamie Marie Lockard, FNP-C
• Ruby Jane Locke, PTA
• April Dawn Lockman, FNP

• Physician Assistant in Statesville, NC
• Providers in Statesville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.