Healthcare Provider Details

I. General information

NPI: 1972412799
Provider Name (Legal Business Name): JOHN ROBERT PIPPIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 DILLON CT
ROCKY MOUNT NC
27803-1364
US

IV. Provider business mailing address

105 DILLON CT
ROCKY MOUNT NC
27803-1364
US

V. Phone/Fax

Practice location:
  • Phone: 252-955-4765
  • Fax:
Mailing address:
  • Phone: 252-955-4765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: