Active NPI
William C Sippo, MD
- Surgery Physician
- Farmington, MO
National Provider Identifier
1861488439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 036091851
- Practice address
- 1101 Weber Rd
Suite 205
Farmington, MO 63640-3352 - Phone
- (573) 756-8400
- Fax
- (573) 756-8403
- NPI assigned
- Sep 20, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 036091851 | IL | Primary |
Addresses
Primary practice location
1101 Weber Rd
Suite 205
Farmington, MO 63640-3352
Mailing address
1101 Weber Rd
Uite 205
Farmington, MO 63640-3352
Phone (573) 756-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 371352599001 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Memorial Medical Group Inc | Past | Accepting new patients | |
| Baptist Memorial Medical Group Inc | Surgery | Past | Accepting new patients |
| Mineral Area Osteopathic Hospital Inc | Past | Accepting new patients |
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.
-
- Nurse Practitioner
- Farmington, MO
- NPI 1124220637
-
- Community/Retail Pharmacy
- Memphis, TN
- NPI 1841006129
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1861488439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 WEBER RD",
"address_2": "UITE 205",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636403352",
"telephone_number": "573-756-8400",
"fax_number": "573-756-8403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 WEBER RD",
"address_2": "SUITE 205",
"city": "FARMINGTON",
"state": "MO",
"postal_code": "636403352",
"telephone_number": "573-756-8400",
"fax_number": "573-756-8403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIPPO",
"first_name": "WILLIAM",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "036091851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "371352599001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.