Individual provider Active NPI

Ticaria Lynne Lipsey, M.D.

  • Obstetrics & Gynecology Physician
  • Tyrone, GA
National Provider Identifier
1972795995
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
068058 Issued in GA
Practice address
190 Handley Rd
Suite a
Tyrone, GA 30290-2178
Phone
(770) 997-5714
NPI assigned
Aug 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 068058 GA Primary

Addresses

Primary practice location

190 Handley Rd
Suite a
Tyrone, GA 30290-2178

Mailing address

190 Handley Rd
Suite a
Tyrone, GA 30290-2178
Phone (770) 997-5714

Other identifiers 1

IdentifierTypeStateIssuer
003126108AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121004000316 GA Practitioner - Obstetrics/Gynecology 3971752023 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2007
Medicare assignment
May accept Medicare assignment
Group practices
WMC Tyrone LLCGroup PAC ID 7113090705, 6 clinicians

Practice addresses (Care Compare)

190 Handley Rd
Suite a
Tyrone, GA 30290-2178
Phone (770) 997-5714

Hospital & facility affiliations

  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
068058GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
WMC Tyrone LLC CurrentSince Sep 4, 2012 Accepting new patients

Locations

190 Handley Rd
Tyrone, GA 30290
Phone (678) 904-7053

190 Handley Rd
Ste A
Tyrone, GA 30290
Phone (770) 997-5714

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.

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": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459987200000",
    "number": "1972795995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HANDLEY RD",
            "address_2": "SUITE A",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902178",
            "telephone_number": "770-997-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HANDLEY RD",
            "address_2": "SUITE A",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902178",
            "telephone_number": "770-997-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPSEY",
        "first_name": "TICARIA",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2016-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "068058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003126108A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyrone, GA

Sources for this page

Verify at the official NPI Registry.