Dina Louise Ivy, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703122032 Issued in MI

Practice address

245 Pitkin St
Highland Park, MI 48203-3737

Phone

(313) 865-1500

NPI assigned

Nov 14, 2025

Last updated

Nov 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1763078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1235099078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MOSS ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482032712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 PITKIN ST",
            "city": "HIGHLAND PARK",
            "state": "MI",
            "postal_code": "482033737",
            "telephone_number": "313-865-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "DINA",
        "middle_name": "LOUISE",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-14",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703122032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Licensed Practical Nurse in Highland Park, MI
• Providers in Highland Park, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.