Individual provider Active NPI

Jordan Douglas Lipton, M.D.

  • Internal Medicine Physician
  • Charlotte, NC
National Provider Identifier
1831158856
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36561 Issued in NC
Practice address
6115 Park South Dr
Suite 100
Charlotte, NC 28210-3269
Phone
(704) 554-8787
Fax
(704) 554-8774
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36561 NC Primary

Addresses

Primary practice location

6115 Park South Dr
Suite 100
Charlotte, NC 28210-3269

Mailing address

6115 Park South Dr
Suite 100
Charlotte, NC 28210-3269
Phone (704) 554-8787

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040909000950 NC Practitioner - Family Practice 9739155755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare PLLCGroup PAC ID 3476678053, 15 clinicians

Practice addresses (Care Compare)

6115 Park S Dr
Suite 100
Charlotte, NC 28210-3281
Phone (704) 554-8787

Merit-based Incentive Payment System (MIPS)

Final score
89.21 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
64.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36561NCMDInternal Medicine Physician
15847NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare PLLC Internal Medicine CurrentSince Feb 1, 2003 Accepting new patients
Piedmont Emergency Medical Associates, PA Past Accepting new patients
Sterling Emergency Services of the Southeast, Inc Past Accepting new patients
Emergency Medicine Physicians of Gaston County, PLLC Past Accepting new patients

Locations

6115 Park South Dr
Ste 100
Charlotte, NC 28210
Phone (704) 554-8787

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19260/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jordan.lipton.1@19260.direct.athenahealth.com

Organizations & group practices 4

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1831158856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103269",
            "telephone_number": "704-554-8787",
            "fax_number": "704-554-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 PARK SOUTH DR",
            "address_2": "SUITE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282103269",
            "telephone_number": "704-554-8787",
            "fax_number": "704-554-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTON",
        "first_name": "JORDAN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "36561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.