CARLY D HIPP (NPI# 1770125197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770125197 |
| Entity Type | Individual |
| Full Name | CARLY D HIPP |
| Practice Address |
277 Buddy Ganem Dr Ste A Portland TX 78374-3202 |
| Practice Telephone | 3617773900 |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
792051 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
277 BUDDY GANEM DR STE A |
| City | PORTLAND |
| State | TX |
| Zip Code | 78374-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063054716 | Lori P Balchik | Nurse Practitioner | 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 | 2019-10-15 |
| 1154949600 | Marka Jane Dredla | Nurse Practitioner | 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 | 2020-07-10 |
| 1932749892 | Travis Wayne Zaplac | Nurse Practitioner | 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 | 2020-01-08 |
| 1518502160 | Brandy Lynn Crowson | Nurse Practitioner | 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 | 2019-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700407350 | Emad Banoub | Pharmacist | 1105 Hyw 181, Portland, TX 78374 | 2020-05-05 |
| 1184256893 | Rebecca Lovins | Behavior Technician | 304, Frio Dr, Portland, TX 78374 | 2020-02-11 |
| 1760962997 | Kimberly Beal | Licensed Vocational Nurse | 201 Sabine St, Portland, TX 78374 | 2018-08-16 |
| 1134577836 | Christopher Tipton | Specialist/Technologist | 4800 Wildcat Dr., Portland, TX 78374 | 2016-06-03 |
| 1134592629 | Coastal Bend Physicians Pllc | Clinic/Center | 1860 Us Highway 181, Suite C, Portland, TX 78374 | 2015-11-05 |
| 1093191397 | Coastal Er IIi, LLC | Clinic/Center | 1860 Highway 181 Frontage Road, Ste C, Portland, TX 78374 | 2015-08-10 |
| 1376942466 | Allen Portland Dentistry Associates Pllc | Dentist | 101 Cox Dr., Portland, TX 78374 | 2014-08-14 |
| 1699188284 | Leola Brumley | Speech-Language Pathologist | 2002 Matagorda Dr., Portland, TX 78374 | 2014-06-11 |
| 1780937607 | Erika Kristine De La Garza | Nurse Practitioner | 1702 Hwy. 181 North, Portland, TX 78374 | 2012-10-16 |
| 1538355219 | Andrew Marcus Rosendahl | Physician Assistant | 1912 Falcon Drive, Portland, TX 78374 | 2007-09-17 |
| Find all providers in zip 78374 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477197705 | Kelsey-jo Audrey Moss | Nurse Practitioner | 704b Ne 62nd Ave, Portland, OR 97213-4351 | 2019-10-30 |
| 1063054716 | Lori P Balchik | Nurse Practitioner | 277 Buddy Ganem Dr Ste A, Portland, TX 78374-3202 | 2019-10-15 |
| 1295273399 | Shaudine Woody | Nurse Practitioner | 11790 Sw Barnes Rd Ste 140, Portland, OR 97225-5938 | 2017-02-08 |
| 1003239120 | Iva Juric | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239-3011 | 2014-01-24 |
| 1811249592 | Pollee Hruby Brookings | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # Cdw7, Portland, OR 97239-3098 | 2012-10-05 |
| 1033470646 | Chelsea Doherty | Nurse Practitioner | 14480 Sw 90th Ave, Portland, OR 97224 | 2012-05-31 |
| 1265699508 | Mallory Johnson | Nurse Practitioner | 11790 Sw Barnes Rd. Blg A, Ste 140, Portland, OR 97225 | 2008-05-22 |
| 1053320804 | Karen Elizabeth Caines | Nurse Practitioner | 96 Falmouth St, Portland, ME 04104-9300 | 2006-08-07 |
| 1649209982 | Joanne M Perry | Nurse Practitioner | 901 Washington Ave Ste 100, Portland, ME 04103-2842 | 2006-06-30 |
| 1497377220 | Erika Lynn Rodakowski | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-05-14 |
| Find all providers in PORTLAND | ||||
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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.