Individual provider Active NPI

Jarrod Blaire Lippy, D.C.

  • Chiropractor
  • Baltimore, MD
National Provider Identifier
1790795334
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
02161S Issued in MD
Practice address
516 N Charles St
Baltimore, MD 21201-5021
Phone
(410) 347-3590
Fax
(410) 347-3592
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 02161S MD Primary

Addresses

Primary practice location

516 N Charles St
Baltimore, MD 21201-5021

Mailing address

901 Maiden Choice LN
Baltimore, MD 21229-4840
Phone (443) 983-1987

Other identifiers 1

IdentifierTypeStateIssuer
403792800MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101210000984 MD Practitioner - Chiropractic 7113114547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

516 N Charles St
Baltimore, MD 21201-5021
Phone (410) 347-3590

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02161SMDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lippy Chiropractic PC Chiropractor CurrentSince Oct 1, 2017 Accepting new patients

Locations

421 N Charles St
Baltimore, MD 21201
Phone (410) 347-3590

516 N Charles St
Baltimore, MD 21201
Phone (410) 347-3590

516 N Charles St
Ste 302
Baltimore, MD 21201
Phone (410) 831-2138

Organizations & group practices 1

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1790795334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MAIDEN CHOICE LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212294840",
            "telephone_number": "443-983-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212015021",
            "telephone_number": "410-347-3590",
            "fax_number": "410-347-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPY",
        "first_name": "JARROD",
        "middle_name": "BLAIRE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "02161S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "403792800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.