Individual provider Active NPI

Tina S. Ipe, MD

  • Clinical Pathology/Laboratory Medicine Physician
  • Little Rock, AR
National Provider Identifier
1972746048
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
E-12325 Issued in AR
Practice address
15300 Kanis Rd
Little Rock, AR 72223-2004
Phone
(817) 689-5139
NPI assigned
Apr 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X E-12325 AR
Clinical Pathology Physician 207ZC0006X E-12325 AR
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X E-12325 AR Primary

Addresses

Primary practice location

15300 Kanis Rd
Little Rock, AR 72223-2004

Mailing address

15300 Kanis Rd
Little Rock, AR 72223-2004
Phone (817) 689-5139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191127001947 AR Practitioner - Pathology 5193968931 Reassigns benefits to 3 organizations
I20240510000364 AR Practitioner - Single Or Multispecialty Clinic Or Group Practice 5193968931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-12325ARMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Children'S Hospital CurrentSince Nov 9, 2019 Accepting new patients
Center for Apheresis and Regenerative Medicine PLLC Blood Banking & Transfusion Medicine CurrentSince Nov 27, 2023 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 21, 2019 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
Arkansas Childrens Hospital CurrentSince Nov 9, 2019 Accepting new patients
University of Arkansas for Medical Sciences Current Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 21, 2019 Accepting new patients
University of Arkansas for Medical Sciences CurrentSince Sep 21, 2019 Accepting new patients
Methodist Pathology Associates PLLC Blood Banking & Transfusion Medicine PastSince Aug 3, 2025 Accepting new patients

Locations

4301 W Markham St
#783
Little Rock, AR 72205
Phone (501) 603-1278

1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874

1 Childrens Way
#653
Little Rock, AR 72202
Phone (501) 614-2006

4301 W Markham St
Little Rock, AR 72205
Phone (501) 603-1278

15300 Kanis Rd
Little Rock, AR 72223
Phone (501) 821-1234

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEHDDD/Endpoint/JEHDDD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1972746048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15300 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722232004",
            "telephone_number": "817-689-5139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15300 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722232004",
            "telephone_number": "817-689-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPE",
        "first_name": "TINA",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-20",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "AR",
            "license": "E-12325",
            "primary": false
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology",
            "state": "AR",
            "license": "E-12325",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "AR",
            "license": "E-12325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.