Active NPI
Irene Anna Royko, M.D.
- Family Medicine Physician
- Prescott, AZ
National Provider Identifier
1124156997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 15680
- Practice address
- 1654 Coyote Rd
Prescott, AZ 86303-5339 - Phone
- (928) 778-4767
- Fax
- (928) 778-4767
- NPI assigned
- Mar 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15680 | AZ | Primary |
Addresses
Primary practice location
1654 Coyote Rd
Prescott, AZ 86303-5339
Mailing address
1654 Coyote Rd
Prescott, AZ 86303-5339
Phone (928) 778-4767
Other names 1
- Mrs. Irene Anna Michelson
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15680 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124156997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1654 COYOTE RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863035339",
"telephone_number": "928-778-4767",
"fax_number": "928-778-4767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1654 COYOTE RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863035339",
"telephone_number": "928-778-4767",
"fax_number": "928-778-4767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYKO",
"first_name": "IRENE",
"middle_name": "ANNA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "15680",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "IRENE",
"last_name": "MICHELSON",
"middle_name": "ANNA",
"prefix": "MRS.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.