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SHANE TIPTON NP NPI 1114321775


NPI Information

NPI: 1114321775
Provider Name: SHANE TIPTON, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
6363 FOREST PARK ROAD 7TH FLOOR STE 749
DALLAS, TX
ZIP 75390
Phone: (214) 645-8500
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Shane Tipton, NP is a psychiatric/mental health nurse practitioner in Dallas, TX. Shane Tipton, NP NPI is 1114321775. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6363 FOREST PARK ROAD 7TH FLOOR STE 749
DALLAS, TX
ZIP 75390-426
Phone: (214) 645-8500
Fax: (214) 645-3775

The NPI 1114321775 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Psychiatric diagnostic evaluation with medical services (HCPCS:90792)

The enumeration date for this NPI number is 10/10/2014 and was last updated on 7/10/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363LP0808XNurse PractitionerPsychiatric/Mental Health675434TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1376416YKQLMEDICARE PINTEXAS
2376416YKP5MEDICARE PINTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.