Active NPI
Bethany Rippy, DMD
- Dentist
- Jefferson City, MO
National Provider Identifier
1689179673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2018019155
- Practice address
- 1511 Christy Dr
Jefferson City, MO 65101-2854 - Phone
- (573) 632-2777
- NPI assigned
- Mar 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2018019155 | MO | Primary |
Addresses
Primary practice location
1511 Christy Dr
Jefferson City, MO 65101-2854
Mailing address
923 W Pershing St Apt B
Springfield, MO 65806-1944
Phone (660) 221-8479
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190730000908 | MO | Order and Referring Only - Dentist | 9335475359 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2018019155 | MO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559606400000",
"number": "1689179673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "923 W PERSHING ST APT B",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658061944",
"telephone_number": "660-221-8479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1511 CHRISTY DR",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651012854",
"telephone_number": "573-632-2777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIPPY",
"first_name": "BETHANY",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-29",
"last_updated": "2019-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2018019155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.