JUSTIN TYLER LIPSEY PA
Complete NPI Record 1053984013
Physician Assistant - Medical in Winchester, VA
Active since July 19, 2021PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Justin Tyler Lipsey, PA (NPI 1053984013), an individual physician assistant provider in Winchester, VA. All 29 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1053984013 Field 1/29
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/29
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: LIPSEY Field 3/29
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JUSTIN Field 4/29
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: TYLER Field 5/29
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: PA Field 6/29
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 220 CAMPUS BLVD STE 100 Field 7/29
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: WINCHESTER Field 8/29
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: VA Field 9/29
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 226012896 Field 10/29
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/29
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 5405365100 Field 12/29
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 5405360235 Field 13/29
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 611 E JUBAL EARLY DR Field 14/29
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: WINCHESTER Field 15/29
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: VA Field 16/29
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 226015178 Field 17/29
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/29
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 5405365500 Field 19/29
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 5405365507 Field 20/29
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 23/29
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363AM0700X Field 24/29
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 0110007917 Field 25/29
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: VA Field 26/29
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 27/29
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 28/29
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 8
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
160 Merchant St Ste 200
Location 1/8Winchester, VA 22603-4772 · Phone (540) 536-5950 · Fax (540) 536-5955
5301 Main St
Location 2/8Mount Jackson, VA 22842-9649 · Phone (540) 459-1250 · Fax (540) 459-1251
33820 Old Valley Pike Ste 2
Location 3/8Strasburg, VA 22657-3793 · Phone (540) 459-1310 · Fax (540) 459-1311
415A South St
Location 4/8Front Royal, VA 22630-2115 · Phone (540) 636-0495 · Fax (540) 636-0450
65 Riverton Commons Dr
Location 5/8Front Royal, VA 22630-6768 · Phone (540) 635-0700
607 E Jubal Early Dr
Location 6/8Winchester, VA 22601-5178 · Phone (540) 536-2232 · Fax (540) 536-2206
160 Merchant St Ste 100
Location 7/8Winchester, VA 22603-4772 · Phone (540) 536-5560 · Fax (540) 536-5561
1440 Amherst St
Location 8/8Winchester, VA 22601-3010 · Phone (540) 536-5400 · Fax (540) 536-5490
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