Walter Stuart Tipton, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS0000003187 Issued in TN

Practice address

1205 George Ave
Jefferson City, TN 37760-2759

Phone

(865) 475-8988

Fax

(865) 475-1103

NPI assigned

Aug 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 TN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Jefferson Dental

  • Dental Clinic/Center
  • Jefferson City, TN
  • NPI 1083975221
  NPD (past)
• Reagan Gentle Dental, PLLC

  • Dental Clinic/Center
  • Jefferson City, TN
  • NPI 1073358362
  NPD (past)

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982616694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 GEORGE AVE",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602759",
            "telephone_number": "865-475-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 GEORGE AVE",
            "city": "JEFFERSON CITY",
            "state": "TN",
            "postal_code": "377602759",
            "telephone_number": "865-475-8988",
            "fax_number": "865-475-1103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "WALTER",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS0000003187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tennessee Cancer Specialists, PLLC
• Tennessee CVS Pharmacy LLC (CVS Pharmacy #03769)
• Tennessee Nursing Services of Morristown, Inc. (Beacon Home Care)
• Therapeuticoncepts
• Therapeuticoncepts
• Hong I Tjoa, MD
• Laura Holeman Trahan, PHARMD
• David Scott Turner Jr., PHARM D
• Unc Style Barbershop and Suites, LLC
• Unity Medical Group PLLC

• General Practice Dentistry in Jefferson City, TN
• Providers in Jefferson City, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.