Individual provider Active NPI

Benjamin Lippe, MPT

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1932183787
Registry record updated Mar 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05005650A Issued in IN
Practice address
533 W Columbia St
Evansville, IN 47710-1617
Phone
(812) 759-3001
Fax
(812) 401-9013
NPI assigned
Dec 5, 2005
Last updated
Mar 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05005650A IN Primary
Physical Therapist 225100000X 005391 KY

Addresses

Primary practice location

533 W Columbia St
Evansville, IN 47710-1617

Mailing address

7300 E Indiana St
Ste. 102
Evansville, IN 47715-2794
Phone (812) 476-0409

Other identifiers 3

IdentifierTypeStateIssuer
000000280217OtherINBLUE CROSS BLUE SHIELD
200818630MedicaidIN
P00060081OtherINMEDICARE RAILROAD

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

State licenses

LicenseStateTypeSpecialty
05005650AINMDPhysical Therapist
005391KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prorehab Inc Physical Therapist 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237161600000",
    "number": "1932183787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 E INDIANA ST",
            "address_2": "STE. 102",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477152794",
            "telephone_number": "812-476-0409",
            "fax_number": "812-476-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 W COLUMBIA ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101617",
            "telephone_number": "812-759-3001",
            "fax_number": "812-401-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPPE",
        "first_name": "BENJAMIN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2009-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05005650A",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "005391",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000280217",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200818630",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00060081",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.