Active NPI
Claire Kipp, PA-C
- Physician Assistant
- Fort Worth, TX
National Provider Identifier
1780156778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA12422
- Practice address
- 1500 Cooper St
Fort Worth, TX 76104-2710 - Phone
- (682) 885-7770
- NPI assigned
- Jan 1, 2019
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA12422 | TX | Primary |
Addresses
Primary practice location
1500 Cooper St
Fort Worth, TX 76104-2710
Mailing address
PO Box 733784
Dallas, TX 75373-3784
Phone (682) 885-6483
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ckipp187105@CookChildrens.direct-ci.com |
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA12422 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Children'S Physician Network | Current | Accepting new patients |
Locations
801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054
1500 Cooper St
Ft Worth, TX 76104
Phone (682) 885-2500
136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412
Interoperability endpoints
- ckipp187105@cookchildrens.direct-ci.com
- ckipp95629@direct.phhs.org
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1750369203
-
- Emergency Medicine Physician
- Fort Worth, TX
- NPI 1285922542
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1083472062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663718400000",
"number": "1780156778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 733784",
"city": "DALLAS",
"state": "TX",
"postal_code": "753733784",
"telephone_number": "682-885-6483",
"fax_number": "682-885-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 COOPER ST",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042710",
"telephone_number": "682-885-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIPP",
"first_name": "CLAIRE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-01",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA12422",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ckipp187105@CookChildrens.direct-ci.com",
"affiliation": "N",
"address_1": "1500 Cooper St",
"city": "Fort Worth",
"state": "TX",
"country_code": "US",
"postal_code": "761042710",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.