NPIMap

Individual provider Active NPI

Philip Brian Tippin, M.D.

  • Family Medicine Physician
  • Danville, AR
National Provider Identifier
1760451876
Registry record updated Jul 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C7881 Issued in AR
Practice address
804 Dan Ark Circle
Danville, AR 72833-0220
Phone
(479) 495-7300
NPI assigned
Mar 14, 2006
Last updated
Jul 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2016

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 C7881 AR Primary

Addresses

Primary practice location

804 Dan Ark Circle
Danville, AR 72833-0220

Mailing address

804 Dan Ark Circle
Danville, AR 72833-0220
Phone (479) 495-7300

Other identifiers 2

IdentifierTypeStateIssuer
117973001MedicaidAR
CS8405OtherARRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040204000726 AR Practitioner - Family Practice 7810880762 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tippin Family Medicine Clinic, P. a.Group PAC ID 7315831542, 2 clinicians

Practice addresses (Care Compare)

719 Detroit Ave
Danville, AR 72833-9607
Phone (479) 495-6270

804 Danark Circle
Danville, AR 72833-0220
Phone (479) 495-7300

PO Box
Suite 639
Danville, AR 72833-0639

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.36 of 100Reported as group
Quality
65.03
Promoting interoperability
99
Improvement activities
40
Cost
76.57

Merit-based Incentive Payment System (MIPS)

Final score
21.72 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
72.39

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C7881ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John Ed Chambers Memorial Hospital, Inc. CurrentSince Dec 23, 2017 Accepting new patients
John Ed Chambers Memorial Hospital, Inc CurrentSince Dec 23, 2017 Accepting new patients
Tippin Family Medicine Clinic, P. a. Family Medicine CurrentSince Aug 31, 1992 Accepting new patients

Locations

719 Detroit Ave
Danville, AR 72833
Phone (479) 495-2241

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJIBCA/Endpoint/JJIBCA
  • Direct secure messaging: philip.tippin@pti.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 13

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

View all 13

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": "1468368000000",
    "number": "1760451876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 DAN ARK CIRCLE",
            "city": "DANVILLE",
            "state": "AR",
            "postal_code": "728330220",
            "telephone_number": "479-495-7300",
            "fax_number": "479-495-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 DAN ARK CIRCLE",
            "city": "DANVILLE",
            "state": "AR",
            "postal_code": "728330220",
            "telephone_number": "479-495-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPIN",
        "first_name": "PHILIP",
        "middle_name": "BRIAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C7881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117973001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CS8405",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, AR

Sources for this page

Verify at the official NPI Registry.