Individual provider Active NPI

Heather Ross Tipsword, D.O.

  • Family Medicine Physician
  • Miramar, FL
National Provider Identifier
1902804248
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3988 Issued in OK
Practice address
3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308
Phone
(954) 399-4621
Fax
(877) 892-9770
NPI assigned
Jul 11, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3988 OK Primary

Addresses

Primary practice location

3601 SW 160TH Ave
Suite 250
Miramar, FL 33027-6308

Mailing address

2514 North Meridian Avenue
Oklahoma City, OK 73107-1035
Phone (405) 722-1110

Other identifiers 1

IdentifierTypeStateIssuer
100114030AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180619001343 TX Order and Referring Only - Family PracticePractitioner - Family Practice 4789574260

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3988OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ahs Oklahoma Physician Group LLC Family Medicine Past Accepting new patients
Summit Medical Center Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://epicproxy.ardenthealth.com/fhir/UPC/api/FHIR/R4

Organizations & group practices 2

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1902804248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2514 NORTH MERIDIAN AVENUE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071035",
            "telephone_number": "405-722-1110",
            "fax_number": "405-721-8263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 SW 160TH AVE",
            "address_2": "SUITE 250",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330276308",
            "telephone_number": "954-399-4621",
            "fax_number": "877-892-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPSWORD",
        "first_name": "HEATHER",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "3988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100114030A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.