Individual provider Active NPI

Patricia Sue Kipper, AA-C

  • Anesthesiologist Assistant
  • Newnan, GA
National Provider Identifier
1922447002
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
2013-018220 Issued in MO
Practice address
745 Poplar Rd
Newnan, GA 30265-1618
Phone
(770) 400-1000
NPI assigned
Jun 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 2013-018220 MO Primary

Addresses

Primary practice location

745 Poplar Rd
Newnan, GA 30265-1618

Mailing address

PO Box 5
Hazelwood, MO 63042-0005
Phone (314) 895-3828

Other practice location 1

10 Hospital Dr
Saint Peters, MO 63376-1659
Phone (314) 895-3828

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20131007000916 MO Practitioner - Anesthesiology Assistant 0749414761 Reassigns benefits to 3 organizations
I20250205001016 GA Practitioner - Anesthesiology Assistant 0749414761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Anesthesia LLCGroup PAC ID 2163837972, 555 clinicians

Practice addresses (Care Compare)

1255 Hwy 54 W
Fayetteville, GA 30214
Phone (770) 719-7000

Hospital & facility affiliations

  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Merit-based Incentive Payment System (MIPS)

Final score
81.37 of 100Reported as group
Quality
60.15
Promoting interoperability
100
Improvement activities
40
Cost
77.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
2013-018220MOMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Anesthesia LLC CurrentSince May 1, 2025 Accepting new patients
Freeman-Oak Hill Health System CurrentSince Aug 31, 2022 Accepting new patients
Professional Anesthetic Care Inc CurrentSince Jul 19, 2019 Accepting new patients
Piedmont Anesthesia Associates, L.L.C CurrentSince Jan 1, 2025 Accepting new patients
Ozark Anesthesia Associates, Inc. CurrentSince Aug 26, 2024 Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 515
Atlanta, GA 30309
Phone (404) 351-1754

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

1102 W 32nd St
Joplin, MO 64804
Phone (417) 347-1078

307 W 11th St
Lamar, MO 64759
Phone (417) 682-3300

2525 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 781-7200

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

1000 E Primrose St
Ste 520
Springfield, MO 65807
Phone (417) 269-4557

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1922447002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630420005",
            "telephone_number": "314-895-3828",
            "fax_number": "314-895-3827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "770-400-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761659",
            "country_code": "US",
            "telephone_number": "314-895-3828",
            "fax_number": "314-895-3827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIPPER",
        "first_name": "PATRICIA",
        "middle_name": "SUE",
        "credential": "AA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-21",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": "2013-018220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.