Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Jake Bradley Lipps

Individual provider Certified Registered Nurse Anesthetist · NPI 1659985596

Mr. Jake Bradley Lipps is a Certified Registered Nurse Anesthetist (CRNA) in Ponchatoula, Louisiana. Qualified in 2024, 2 years ago. Practices with Louisiana State University School of Medicine in New Orleans Faculty G, a 447-clinician group and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
2
Licensed in
LA
In the registry since
2020

Practice location Address checks out

40068 Davis Dr
Ponchatoula, LA 70454-6410
Phone: (985) 974-9687
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 236041 (LA)

Record details

NPI number1659985596
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 8, 2020
Last updated in NPPESJuly 11, 2024
Certification dateJuly 11, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Louisiana State University School Of Medicine In New Orleans Faculty G — 447 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Ponchatoula