Healthcare Provider Details

I. General information

NPI: 1780515205
Provider Name (Legal Business Name): JAMES TIPTON LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 KINGSBURY WAY
HAMPTON VA
23666-2996
US

IV. Provider business mailing address

18 KINGSBURY WAY
HAMPTON VA
23666-2996
US

V. Phone/Fax

Practice location:
  • Phone: 352-286-7494
  • Fax:
Mailing address:
  • Phone: 352-286-7494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number0002107175
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: