Active NPI
Tracy Hugh Tippets, RPA
- Radiology Practitioner Assistant
- Kaysville, UT
National Provider Identifier
1902042104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Practitioner Assistant
- License
- 09 UT 1-14
- Practice address
- 240 Oak LN
Kaysville, UT 84037-1635 - Phone
- (801) 543-1301
- NPI assigned
- Dec 18, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Practitioner Assistant | 243U00000X | 09 UT 1-14 | UT | Primary |
| Radiography Radiologic Technologist | 2471C3402X | 119162-5401 | UT |
Addresses
Primary practice location
240 Oak LN
Kaysville, UT 84037-1635
Mailing address
240 Oak LN
Kaysville, UT 84037-1635
Phone (801) 543-1301
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09 UT 1-14 | UT | MD | Radiology Practitioner Assistant |
| 119162-5401 | UT | MD | Radiography Radiologic Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229558400000",
"number": "1902042104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 OAK LN",
"city": "KAYSVILLE",
"state": "UT",
"postal_code": "840371635",
"telephone_number": "801-543-1301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 OAK LN",
"city": "KAYSVILLE",
"state": "UT",
"postal_code": "840371635",
"telephone_number": "801-543-1301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPPETS",
"first_name": "TRACY",
"middle_name": "HUGH",
"name_prefix": "Mr.",
"credential": "RPA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-12-18",
"last_updated": "2008-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "243U00000X",
"taxonomy_group": "",
"desc": "Radiology Practitioner Assistant",
"state": "UT",
"license": "09 UT 1-14",
"primary": true
},
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "UT",
"license": "119162-5401",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kaysville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.