DR. JACK MORGAN LIPPS (NPI# 1487621132) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487621132 |
| Entity Type | Individual |
| Full Name | DR. JACK MORGAN LIPPS |
| Credential | MD |
| Practice Address |
4202 E Fowler Ave Shs 100 Tampa FL 33620-6750 |
| Mailing Address |
Po Box 917770 Orlando FL 32891-7770 |
| Practice Telephone | 8139742331 |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2016-02-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | ME38761 | FL | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | ME38761 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 62330 | 01 |
| FL | 280479400 | 05 |
| Street Address |
4202 E FOWLER AVE SHS 100 |
| City | TAMPA |
| State | FL |
| Zip Code | 33620-6750 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992793004 | Melissa M Bailey | Nurse Practitioner | 4202 E Fowler Ave, Shs100, Tampa, FL 33620-6750 | 2005-10-12 |
| 1023615226 | Allison Bootz | Student in an Organized Health Care Education/Training Program | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2020-10-01 |
| 1265050926 | Macy Franklin | Specialist/Technologist | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2020-07-09 |
| 1043834351 | Marian Alice Lowther | Speech-Language Pathologist | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2020-06-02 |
| 1235750928 | Bethany Moorhouse | Student in an Organized Health Care Education/Training Program | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2020-05-04 |
| 1245872985 | Stacey Julia Struhar | Dietitian, Registered | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2019-10-15 |
| 1609439074 | Khalid Shakfeh | Student in an Organized Health Care Education/Training Program | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2019-04-20 |
| 1598228256 | Isabella Abbasi | Specialist/Technologist | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2019-04-10 |
| 1396201448 | Vanessa Chantal Barber | Social Worker | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2019-02-13 |
| 1588128698 | Kassandra Lynch | Specialist/Technologist | 4202 E Fowler Ave, Tampa, FL 33620-8000 | 2019-01-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689145542 | Ramon Ramirez | Specialist/Technologist | 4202 E Fowler Ave., Ath 100, Tampa, FL 33620 | 2018-12-17 |
| 1093818908 | Theresa Hnath-chisolm | Audiologist | 4202 E Fowler Aveune, University of South Florida PCd 1017, Tampa, FL 33620 | 2006-09-06 |
| 1215303805 | Kaitlyn Rechenberg | Nurse Practitioner | 4202 E Fowler Ave Stop Shs100, Tampa, FL 33620 | 2015-08-18 |
| 1245527738 | Kelli Gorajec | Speech-Language Pathologist | 4202 E Fowler Ave Stop PCd1017, Tampa, FL 33620 | 2011-07-05 |
| 1487843637 | Jane Bradley Smart | Speech-Language Pathologist | 4202 E Fowler Ave Stop PCd1017, Tampa, FL 33620 | 2007-10-23 |
| 1912082199 | Rebecca Marie Lutz | Nurse Practitioner | 4202 E Fowler Ave Stop Shs100, Tampa, FL 33620 | 2006-10-26 |
| 1306956206 | Wendy Weiss | Family Medicine | 4202 E Fowler Ave Stop Shs100, Tampa, FL 33620 | 2006-08-30 |
| 1518472901 | Kacey Garcia Poulin | Speech-Language Pathologist | 4202 E Fowler Ave PCd2000, Tampa, FL 33620-0001 | 2017-12-06 |
| 1598275695 | Laura Anne Marshall | Behavior Technician | Usf Birch Drive, Tampa, FL 33620-0001 | 2017-10-04 |
| 1053793026 | University Medical Service Association Inc | Clinical Medical Laboratory | 4107 Usf Cedar Cir, Ste 171, Tampa, FL 33620-0001 | 2015-06-25 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811459563 | Tampa Bay Premier Obgyn Pllc | Obstetrics & Gynecology | 2727 W Dr Mlk Blvd Ste 630, Tampa, FL 33607-6399 | 2019-04-02 |
| 1033512264 | Tampa Obstetrics, P.a. | Obstetrics & Gynecology | 4503 North 22nd Street, Tampa, FL 33610-6201 | 2014-10-02 |
| 1902209257 | Exodus Women's Center, Inc. | Obstetrics & Gynecology | 4503 N 22nd St, Tampa, FL 33610-6201 | 2014-10-01 |
| 1710388814 | Ana Maria Fraguada | Obstetrics & Gynecology | 3450 E Fletcher Ave Ste 110, Tampa, FL 33613-4603 | 2014-09-08 |
| 1245659010 | Pawan Kumar Rattan | Obstetrics & Gynecology | 612 E Davis Blvd, Tampa, FL 33606-3922 | 2014-04-09 |
| 1356760359 | Exodus Women's Center, Inc. | Obstetrics & Gynecology | 5537 Sheldon Rd Ste N, Tampa, FL 33615-3167 | 2014-04-08 |
| 1124459326 | Michael Fernandez | Obstetrics & Gynecology | 13806 Khilani Ct, Tampa, FL 33624-6919 | 2013-12-12 |
| 1730514225 | Charles Samuel Mahan | Obstetrics & Gynecology | 3111 E. Fletcher Av., Tampa, FL 33611 | 2013-09-04 |
| 1992140677 | Wilfredo Nicolas Herrera | Obstetrics & Gynecology | 2727 W Dr. Mlk Jr Blvd, Ste 630, Tampa, FL 33607 | 2013-05-08 |
| 1912244831 | William Larry Capps | Obstetrics & Gynecology | 577 Luzon Ave, Tampa, FL 33606-3623 | 2013-01-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.