Individual provider Active NPI

Tipton J Brown, DDS

  • Dentist
  • Neenah, WI
National Provider Identifier
1801153853
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4849-015 Issued in WI
Practice address
996 S Green Bay Rd
Neenah, WI 54956-3627
Phone
(920) 725-0400
Fax
(920) 725-0470
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4849-015 WI Primary

Addresses

Primary practice location

996 S Green Bay Rd
Neenah, WI 54956-3627

Mailing address

996 S Green Bay Rd
Neenah, WI 54956-3627
Phone (920) 725-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20150505002617 WI Order and Referring Only - DentistPractitioner - Dentist 4587983002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4849-015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1801153853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "996 S GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563627",
            "telephone_number": "920-725-0400",
            "fax_number": "920-725-0470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "996 S GREEN BAY RD",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563627",
            "telephone_number": "920-725-0400",
            "fax_number": "920-725-0470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TIPTON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4849-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Neenah, WI

Sources for this page

Verify at the official NPI Registry.