Individual provider Active NPI

Philip Emery Pippen, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1992461206
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3018429 Issued in KY
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

Updated by the provider on Apr 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221128002040 KY Practitioner - Nurse Practitioner 2668840588 Reassigns benefits to 1 organization

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
Seven Counties Services, IncGroup PAC ID 1759294424, 92 clinicians

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

LicenseStateTypeSpecialty
1136044KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Seven Counties Services, Inc. CurrentSince Nov 14, 2022 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.

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

Verify at the official NPI Registry.