Active NPI
Vicki Marie Irish, NP(WOMEN'S HEALTH)
- Women's Health Nurse Practitioner
- Detroit, MI
National Provider Identifier
1225025273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 4704208777
- Practice address
- 2799 W Grand Blvd
K-9 Urology
Detroit, MI 48202-2608 - Phone
- (313) 916-2062
- Fax
- (313) 916-8869
- NPI assigned
- Oct 4, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 0024168785 | VA | |
| Women's Health Nurse Practitioner | 363LW0102X | 4704208777 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
K-9 Urology
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
K-9 Urology
Detroit, MI 48202-2608
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | virish309222@direct.hfhs.org | Direct |
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704208777 | MI | MD | Women's Health Nurse Practitioner |
| 0024168785 | VA | MD | Women's Health Nurse Practitioner |
Interoperability endpoints
- virish309222@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617062400000",
"number": "1225025273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"address_2": "K-9 UROLOGY",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"address_2": "K-9 UROLOGY",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-2062",
"fax_number": "313-916-8869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRISH",
"first_name": "VICKI",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "NP(WOMEN'S HEALTH)",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-04",
"last_updated": "2021-03-30",
"certification_date": "2021-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "VA",
"license": "0024168785",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MI",
"license": "4704208777",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "virish309222@direct.hfhs.org",
"affiliation": "N",
"endpointDescription": "direct email address",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2799 W Grand Blvd",
"address_2": "K-9 Urology",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "482022608",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.