Active NPI
Philip Emery Pippen, RN
- Psychiatric/Mental Health Nurse Practitioner
- Louisville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 3018429
- Practice address
- 2650 W Broadway
Louisville, KY 40211-1333 - Phone
- (502) 589-8723
- NPI assigned
- Nov 10, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 3018429 | KY | Primary |
| Registered Nurse | 163W00000X | 1136044 | KY |
Addresses
Primary practice location
2650 W Broadway
Louisville, KY 40211-1333
Mailing address
2650 W Broadway
Louisville, KY 40211-1333
Phone (502) 589-8723
Other practice location 1
1405 Browns Ln
Louisville, KY 40207-4608
Phone (502) 896-0495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
2650 W Broadway
Louisville, KY 40211-1333
Phone (502) 589-1100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1136044 | KY | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seven Counties Services, Inc. | Current | Accepting new patients |
Locations
530 S Jackson St
Louisville, KY 40202
Phone (502) 562-3000
10401 Linn Station Rd
Ste 100
Louisville, KY 40223
2650 W Broadway
Louisville, KY 40211
Phone (502) 589-8723
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Louisville, KY
- NPI 1598793671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1992461206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 W BROADWAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402111333",
"telephone_number": "502-589-8723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 W BROADWAY",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402111333",
"telephone_number": "502-589-8723"
}
],
"practiceLocations": [
{
"address_1": "1405 Browns Ln",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402074608",
"country_code": "US",
"telephone_number": "502-896-0495",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PIPPEN",
"first_name": "PHILIP",
"middle_name": "EMERY",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-11-10",
"last_updated": "2024-04-01",
"certification_date": "2024-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "KY",
"license": "3018429",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KY",
"license": "1136044",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.