Individual provider Active NPI

Ira Lourie, PSY.D.

  • Clinical Neuropsychologist
  • Southfield, MI
National Provider Identifier
1043234859
Registry record updated Oct 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
630100750 Issued in MI
Practice address
28220 Franklin Rd
Southfield, MI 48034-1659
Phone
(248) 788-9708
Fax
(248) 788-9708
NPI assigned
Jul 26, 2006
Last updated
Oct 21, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 630100750 MI Primary
Psychologist 103T00000X 630100750 MI

Addresses

Primary practice location

28220 Franklin Rd
Southfield, MI 48034-1659

Mailing address

PO Box 44047
Detroit, MI 48244-0047
Phone (248) 584-0240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
630100750MIMDPsychologist

Interoperability endpoints

  • Direct secure messaging: ilourie239652@direct.hfhs.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319155200000",
    "number": "1043234859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44047",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482440047",
            "telephone_number": "248-584-0240",
            "fax_number": "248-584-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28220 FRANKLIN RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341659",
            "telephone_number": "248-788-9708",
            "fax_number": "248-788-9708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOURIE",
        "first_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "630100750",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "630100750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.