DR. MARK L LIPHAM MD
NPI 1437192697
Internal Medicine in Carrollton, GA

Q: What is Mark Lipham's NPI number?

The NPI number for Mark Lipham is 1437192697. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Q: What is Mark Lipham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Mark Lipham was last updated on November 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 14, 2006PECOS EnrolledAccepts Medicare Assignment

46.94/100

CMS Quality Rating

105 DOCTORS DRIVE, CARROLLTON, GA 30117(770) 832-0012(770) 832-0685 Get Directions Write a Review

NPPES record last updated: November 13, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Mark L Lipham Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARK L LIPHAM MD (NPI 1437192697) is an individual internal medicine provider in Carrollton, Georgia, licensed in Georgia (19173) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Tanner Medical Center - Carrollton, and is a graduate of Emory University School Of Medicine (1971).

NPPES Registry Identity

NPI1437192697

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. MARK L LIPHAMCredential: MD

Location Address105 DOCTORS DRIVECarrollton, GA 30117

Mailing AddressPo Box 997Carrollton, GA 30112 · (770) 832-0012 · Fax (770) 832-0685

Phone(770) 832-0012

Fax(770) 832-0685

Sole ProprietorYes

Medical School CMSEmory University School Of MedicineGraduated 1971

Enumeration DateJune 14, 2006

Last NPPES UpdateNovember 13, 2024

NPPES CertifiedNovember 13, 2024

✔ NPI 1437192697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in GA · 19173

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X · License 19173 (GA)

105 DOCTORS DRIVE, Carrollton, GA 30117

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Other Identifiers 2

Medicaid000217753AGA

Other024977Blue Shield

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Mark L Lipham Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143394734

PECOS Enrollment IDI20080730000613

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes 99307

A follow-up nursing facility visit per day typically lasts about 10 minutes. This service involves a healthcare professional checking on your health status, answering any questions you may have, and monitoring your progress. This routine check ensures your recovery is on track and any concerns are addressed promptly.

924 services193 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

306 services187 patients

Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305

An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.

215 services205 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

199 services98 patients

Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes 99347

An established patient home visit is a service where a healthcare professional visits your home for a 15-minute check-up. It's designed for patients who have previously seen the professional. The visit may include basic health assessments and discussions about your ongoing care.

74 services26 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

66 services44 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

45 services39 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

44 services13 patients

Advance care planning, first 30 minutes 99497

Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.

30 services30 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

30 services30 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

26 services20 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Tanner Medical Center - Carrollton

Acute Care Hospitals · Carrollton, GA

3/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110011

Location705 Dixie StreetCarrollton, GA 30117 · Carroll County

Birthing friendly

Tanner Medical Center Villa Rica

Acute Care Hospitals · Villa Rica, GA

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110015

Location601 Dallas HighwayVilla Rica, GA 30180 · Carroll County

Emergency services Birthing friendly

Higgins General Hospital

Critical Access Hospitals · Bremen, GA

OwnershipGovernment - Hospital District or Authority

CMS Certification Number111320

Location200 Allen Memorial DriveBremen, GA 30110 · Haralson County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30117 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

46.94/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

Improvement Activities

Cost

83.15

Referred Medical Equipment & Supplies CMS DME claims 16

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

6 suppliers15 claims38 services$6.38 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress E0261

DME-Hospital Beds · category DB000N

1 supplier29 claims29 services$44.67 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

3 suppliers14 claims14 services$16.83 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

1 supplier25 claims25 services$3.14 avg. paid by Medicare

Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) E0630

DME-Other DME · category DE000N

1 supplier12 claims12 services$42.75 avg. paid by Medicare

Manual wheelchair accessory, anti-tipping device, each E0971

DME-Wheelchairs · category DD021N

2 suppliers11 claims22 services$26.41 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Lipham's NPI number?

The NPI number for Mark Lipham is 1437192697. It was assigned to this individual provider in the NPPES registry on June 14, 2006.

Where is Mark Lipham located?

Mark Lipham practices at 105 Doctors Drive, Carrollton, GA 30117. The listed phone number is (770) 832-0012.

What is Mark Lipham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Mark Lipham enrolled in Medicare?

Yes. Mark Lipham is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mark Lipham accept?

Health plans from Alliant Health Plans, Inc. list Mark Lipham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mark Lipham affiliated with any hospitals?

According to CMS data, Mark Lipham is affiliated with Tanner Medical Center - Carrollton, Tanner Medical Center Villa Rica and Higgins General Hospital.

When was this NPI record last updated?

The NPPES record for Mark Lipham was last updated on November 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.