Active NPI
Jennifer R Lippens, O.D.
- Optometrist
- Greenwood, SC
National Provider Identifier
1942269576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- SC1280
- Practice address
- 711 Montague Ave
Greenwood, SC 29649-1440 - Phone
- (864) 229-2301
- Fax
- (864) 229-1898
- NPI assigned
- Mar 22, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | SC1280 | SC | Primary |
Addresses
Primary practice location
711 Montague Ave
Greenwood, SC 29649-1440
Mailing address
PO Box 1206
Greenwood, SC 29648-1206
Phone (864) 229-2301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D12804 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
711 Montague Ave
Greenwood, SC 29649-1440
Phone (864) 229-2301
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC1280 | SC | MD | Optometrist |
| 1280 | SC | MD | Physician Assistant |
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.
-
- Optometrist
- Greenwood, SC
- NPI 1205048964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1942269576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1206",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296481206",
"telephone_number": "864-229-2301",
"fax_number": "864-229-1898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 MONTAGUE AVE",
"city": "GREENWOOD",
"state": "SC",
"postal_code": "296491440",
"telephone_number": "864-229-2301",
"fax_number": "864-229-1898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIPPENS",
"first_name": "JENNIFER",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-22",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "SC",
"license": "SC1280",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D12804",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenwood, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.
- 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.