Shilo Renae Tippett, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2217 Issued in OR

Practice address

480 NE a St
Madras, OR 97741-1844

Phone

(541) 475-4800

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Medicare reassignment NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1932207164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 NE A ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411844",
            "telephone_number": "541-475-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 NE A ST",
            "city": "MADRAS",
            "state": "OR",
            "postal_code": "977411844",
            "telephone_number": "541-475-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPPETT",
        "first_name": "SHILO",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Gunter Stephens, CRM, CADC-R
• Nicolette Linea Stevanovski, PA-C
• Richard Synowski II
• Jessica Brooke Tegen, OD
• Jordy Alexander Tellez
• Andrew Scott Toms, D.D.S.
• Nicolle Tracy
• Jennifer Tripp, PHARM D
• Ema Urieta
• Kim Utter, LMT

• Psychologist in Madras, OR
• Providers in Madras, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.