Provider Demographics
NPI:1265465215
Name:LIPPERT, J'AIMEE A (DO)
Entity Type:Individual
Prefix:DR
First Name:J'AIMEE
Middle Name:A
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD STE A109B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-432-6144
Mailing Address - Fax:517-432-6150
Practice Address - Street 1:4660 S HAGADORN RD STE 500
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6804
Practice Address - Country:US
Practice Address - Phone:517-432-6144
Practice Address - Fax:517-432-6150
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101014683204D00000X, 207Q00000X
WI54254-21207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIK400136365Medicare PIN
WI07028-0286Medicare PIN
MI1265465215Medicaid
MI0D16299066Medicare PIN