MEDICARE: WIMBERLY TIPPING COX NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner	2025002114	MO
2	363LG0600X	Gerontology Nurse Practitioner	37914	TN
3	363LG0600X	Gerontology Nurse Practitioner	C-APN.0101894-C-NP	CO
4	363LG0600X	Gerontology Nurse Practitioner	4033745	KY
5	363LG0600X	Gerontology Nurse Practitioner	3-002082	AL
6	363LG0600X	Gerontology Nurse Practitioner	10053678	OR
7	363LG0600X	Gerontology Nurse Practitioner	14253608-4405	UT
8	363LG0600X	Gerontology Nurse Practitioner	1198891	TX
9	363LG0600X	Gerontology Nurse Practitioner	SP032777	PA
10	363LG0600X	Gerontology Nurse Practitioner	306051	AZ
11	363LG0600X	Gerontology Nurse Practitioner	APRN11036998	FL
12	363LG0600X	Gerontology Nurse Practitioner	71016589A	IN
13	363LG0600X	Gerontology Nurse Practitioner	GAA-NP003236	GA
14	363LG0600X	Gerontology Nurse Practitioner	0038259	OH
15	363LG0600X	Gerontology Nurse Practitioner	17573	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154603611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WIMBERLY TIPPING COX NP

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

Provider Business Practice Location Address
First Line	:	1055 HOWELL MILL RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	12/09/2025

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