Individual provider Active NPI

Jessica Sarah Kathryn Tipton, NP-C

  • Family Nurse Practitioner
  • Huber Heights, OH
National Provider Identifier
1790208577
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021000 Issued in OH
Practice address
8701 Old Troy Pike Ste 10
Huber Heights, OH 45424-1053
Phone
(937) 237-5294
Fax
(937) 237-4748
NPI assigned
Jul 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.021000 OH Primary

Addresses

Primary practice location

8701 Old Troy Pike Ste 10
Huber Heights, OH 45424-1053

Mailing address

500 N Main St
Lewisburg, OH 45338-9503
Phone (937) 297-8999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20170815001260 OH Practitioner - Nurse Practitioner 8729350582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wright State University Boonshoft School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Family Care IncGroup PAC ID 5092608372, 58 clinicians

Practice addresses (Care Compare)

500 N Main St
Lewisburg, OH 45338-9503
Phone (937) 962-2618

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.94 of 100Reported as group
Quality
80.85
Promoting interoperability
99
Improvement activities
40
Cost
79.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Family Care Inc CurrentSince Jan 6, 2020 Accepting new patients
Samaritan Family Care Inc CurrentSince Jan 6, 2020 Accepting new patients
Samaritan Family Care, Inc. Past Accepting new patients

Locations

1530 Needmore Rd
Ste 200
Dayton, OH 45414
Phone (937) 278-5854

500 N Main St
Lewisburg, OH 45338
Phone (937) 962-2618

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1790208577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MAIN ST",
            "city": "LEWISBURG",
            "state": "OH",
            "postal_code": "453389503",
            "telephone_number": "937-297-8999",
            "fax_number": "937-297-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 OLD TROY PIKE STE 10",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241053",
            "telephone_number": "937-237-5294",
            "fax_number": "937-237-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "JESSICA",
        "middle_name": "SARAH KATHRYN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huber Heights, OH

Sources for this page

Verify at the official NPI Registry.