Ivory Lira, RDN

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86049472 Issued in VA

Practice address

15195 Heathcote Blvd Ste 330
Haymarket, VA 20169

Phone

(571) 284-3380

Fax

(571) 284-3389

NPI assigned

Aug 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ivory Miceli Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: imiceli751485@direct.novanthealth.org

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

• Chinook Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Anchorage, AK
  • NPI 1851710750
  NPD (past)

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1114393170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 HEATHCOTE BLVD STE 330",
            "city": "HAYMARKET",
            "state": "VA",
            "postal_code": "20169",
            "telephone_number": "571-284-3380",
            "fax_number": "571-284-3389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15195 Heathcote Blvd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Haymarket",
            "state": "VA",
            "postal_code": "20169",
            "country_code": "US",
            "telephone_number": "571-284-3380",
            "fax_number": "571-284-3389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIRA",
        "first_name": "IVORY",
        "credential": "RDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AK",
            "license": "101206",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "86049472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imiceli751485@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "15195 Heathcote Blvd Ste 330",
            "city": "Haymarket",
            "state": "VA",
            "country_code": "US",
            "postal_code": "20169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "IVORY",
            "last_name": "MICELI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teresa Jeanne Lear, LMFT
• Jennifer Lee
• Andrew Gerald Lewis, DDS
• Valerie T Lewis, SPEECH PATHOLOGIST
• Ji Ah Lim, DDS
• Alexis R Liska
• Helen Hurst Loera, PT, DPT
• Joanna Krekel Losi, M.S., CCC-SLP
• Catherine Ann Love, LPC/LMFT
• Lowe Dental Group and Associates PLLC

• Registered Dietitian in Haymarket, VA
• Providers in Haymarket, VA by specialty
• Registered Dietitian in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.