Individual provider Active NPI

Stephen Thomas Tipton, OD

  • Optometrist
  • Fort Bragg, NC
National Provider Identifier
1730698010
Registry record updated Sep 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC5465 Issued in FL
Practice address
1605 Reilly Rd
Fort Bragg, NC 28307-5001
Phone
(417) 631-3071
NPI assigned
Sep 29, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC5465 FL Primary

Addresses

Primary practice location

1605 Reilly Rd
Fort Bragg, NC 28307-5001

Mailing address

115 Cypress Cir
Southern Pines, NC 28387-7300
Phone (417) 631-3071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210303001193 FL Practitioner - Optometry 2961818729 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Douglas Reynolds, O.D. Santa Rosa, P.a.Group PAC ID 7113286451, 6 clinicians
Douglas Reynolds OD PAGroup PAC ID 3375584295, 8 clinicians

Practice addresses (Care Compare)

4377 Woodbine Rd
Pace, FL 32571-8792
Phone (850) 995-4555

460 E 9 Mile Rd
Pensacola, FL 32514-1441
Phone (850) 477-1499

Merit-based Incentive Payment System (MIPS)

Final score
80.14 of 100Reported as group
Quality
60.29
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Reynolds OD PA Optometrist CurrentSince Feb 15, 2021 Accepting new patients
Douglas Reynolds, O.D. Santa Rosa, P.a. Optometrist CurrentSince Feb 15, 2021 Accepting new patients
Owens & Reynolds Inc Optometrist Past Accepting new patients
F & M of Milton Inc Optometrist PastSince Feb 15, 2021 Accepting new patients

Locations

2491 S Ferdon Blvd
Crestview, FL 32536
Phone (850) 682-4014

5560 Stewart St
Milton, FL 32570
Phone (850) 623-2545

4377 Woodbine Rd
Pace, FL 32571
Phone (850) 995-4555

800 N 12th Ave
Pensacola, FL 32501
Phone (850) 477-1499

460 E Nine Mile Rd
Pensacola, FL 32514
Phone (850) 266-7500

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506643200000",
    "number": "1730698010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CYPRESS CIR",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283877300",
            "telephone_number": "417-631-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 REILLY RD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283075001",
            "telephone_number": "417-631-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "STEPHEN",
        "middle_name": "THOMAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2017-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, NC

Sources for this page

Verify at the official NPI Registry.