Active NPI
Mary D Tipton, MD
- Pediatrics Physician
- West Jordan, UT
National Provider Identifier
1922065598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 5934303-1205
- Practice address
- 3570 W 9000 S Ste 220
West Jordan, UT 84088-8873 - Phone
- (801) 890-3837
- Fax
- (801) 743-7596
- NPI assigned
- Apr 27, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 5934303-1205 | UT | Primary |
| Internal Medicine Physician | 207R00000X | 5934303-1205 | UT |
Addresses
Primary practice location
3570 W 9000 S Ste 220
West Jordan, UT 84088-8873
Mailing address
3570 W 9000 S Ste 220
West Jordan, UT 84088-8873
Phone (801) 890-3837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 11, 2024 through Apr 11, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5934303-1205 | UT | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miami Valley Emergency Specialists, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
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- Dayton, OH
- NPI 1821189085
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780185600000",
"number": "1922065598",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3570 W 9000 S STE 220",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840888873",
"telephone_number": "801-890-3837",
"fax_number": "801-743-7596"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 W 9000 S STE 220",
"city": "WEST JORDAN",
"state": "UT",
"postal_code": "840888873",
"telephone_number": "801-890-3837",
"fax_number": "801-743-7596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIPTON",
"first_name": "MARY",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-27",
"last_updated": "2026-05-31",
"certification_date": "2026-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "5934303-1205",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "5934303-1205",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.