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MRS. MARY CHRISTY LIPSCOMB AG-ACNP-BC
NPI 1790127090
Nurse Practitioner - Acute Care in East Ridge, TN

Active since July 27, 2013PECOS Enrolled
1508 TOMBRAS AVE, EAST RIDGE, TN 37412(423) 867-4969(423) 867-4971 Get Directions Write a Review

NPPES record last updated: January 6, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Mrs. Mary Christy Lipscomb Ag-acnp-bc NPPES

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

MRS. MARY CHRISTY LIPSCOMB AG-ACNP-BC (NPI 1790127090) is an individual acute care provider in East Ridge, Tennessee, licensed in Tennessee (17817) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790127090
Entity TypeIndividualFemale
Primary Taxonomy363LA2100X
Provider Legal NameMRS. MARY CHRISTY LIPSCOMBCredential: AG-ACNP-BC
Location Address1508 TOMBRAS AVEEast Ridge, TN 37412-2720
Mailing Address1508 Tombras AveEast Ridge, TN 37412-2720 · (423) 867-4969 · Fax (423) 867-4971
Phone(423) 867-4969
Fax(423) 867-4971
Sole ProprietorNo
Enumeration DateJuly 27, 2013
Last NPPES UpdateJanuary 6, 2016
✔ NPI 1790127090 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in TN · 17817
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 17817 (TN)
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X · License 17817 (TN)
1508 TOMBRAS AVE, East Ridge, TN 37412
Open in Google Maps ↗

Other Identifiers 3

MedicaidQ014366TN
Medicare PIN10350I2140TN
Other6050407TN · Bcbs Of Tennessee

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Mary Christy Lipscomb Ag-acnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Lipscomb reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cleveland Medical Associates, PLLC
26 mi
Internal Medicine
1060 WILLIAM WAY NW
Cleveland, TN 37312
  • Reassigned Medicare billing, Tennessee enrollment
  • 15 clinicians in this Medicare group
NPI 1093723330 (423) 478-1050
Kaful Double Portion Family Practice, Inc
26 mi
Family
3740 OCOEE PLACE NW, SUITE 101
Cleveland, TN 37312
  • Reassigned Medicare billing, Tennessee enrollment
  • 15 clinicians in this Medicare group
NPI 1386049476 (423) 339-7107

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37412 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
$81.53 typical visit price
range $52.64 – $160.89
Typical copayment $20.38 (range $13.16 – $40.22)
Most-billed visit code 99203
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

Referred Medical Equipment & Supplies CMS DME claims 2

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

Nebulizer, with compressor E0570
DME-Other DME · category DE000N
3 suppliers14 claims14 services$5.29 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier12 claims12 services$21.15 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICIA DIANE BLASICK PA
Physician Assistant (Medical)
1508 TOMBRAS AVE
EAST RIDGE, TN 37412
Hamilton County (423) 867-4969
MS. ANNE REBECCA NEUMANN FNP-C
Nurse Practitioner (Family)
1508 TOMBRAS AVE
EAST RIDGE, TN 37412
Hamilton County (423) 867-4969
MICHELE ROBERTS FNP
Nurse Practitioner (Family)
1508 TOMBRAS AVE
CHATTANOOGA, TN 37412
Hamilton County (423) 867-4974
AMIN SOHANI NP-C
Nurse Practitioner (Family)
1508 TOMBRAS AVE
EAST RIDGE, TN 37412
Hamilton County (423) 867-4969
MARCILE HELEN LEAF FNP-C
Nurse Practitioner (Family)
1508 TOMBRAS AVE
EAST RIDGE, TN 37412
Hamilton County (423) 867-4969
KELLIE LAWRENCE HENDERSON PA
Physician Assistant (Medical)
1508 TOMBRAS AVE
EAST RIDGE, TN 37412
Hamilton County (423) 867-4969
AMY DAWN LATHAM N.P.
Nurse Practitioner (Family)
1508 TOMBRAS AVE
EAST RIDGE, TN 37412
Hamilton County (423) 867-4969
SHANNA MAGLOIRE REGIS FNP-C
Nurse Practitioner (Family)
1508 TOMBRAS AVE
CHATTANOOGA, TN 37412
Hamilton County (423) 867-4969

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 Mary Lipscomb's NPI number?

The NPI number for Mary Lipscomb is 1790127090. It was assigned to this individual provider in the NPPES registry on July 27, 2013.

Where is Mary Lipscomb located?

Mary Lipscomb practices at 1508 Tombras Ave, East Ridge, TN 37412. The listed phone number is (423) 867-4969.

What is Mary Lipscomb's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Mary Lipscomb enrolled in Medicare?

Yes. Mary Lipscomb is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mary Lipscomb's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Lipscomb reassigns Medicare benefits to 2 organizations: Cleveland Medical Associates, PLLC (Cleveland, TN) and Kaful Double Portion Family Practice, Inc (Cleveland, TN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Lipscomb's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Lipscomb was last updated on January 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.