Active NPI
Elizabeth Irwin, O.D.
- Optometrist
- Lincoln Park, MI
National Provider Identifier
1699005165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901003303
- Practice address
- 2100 Southfield Rd
Lincoln Park, MI 48146-2250 - Phone
- (313) 382-8044
- Fax
- (313) 389-3099
- NPI assigned
- Jan 6, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901003303 | MI | Primary |
Addresses
Primary practice location
2100 Southfield Rd
Lincoln Park, MI 48146-2250
Mailing address
46852 Registry Dr
Canton, MI 48187-1689
Phone (734) 416-0152
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4901003303 | MI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262736000000",
"number": "1699005165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46852 REGISTRY DR",
"city": "CANTON",
"state": "MI",
"postal_code": "481871689",
"telephone_number": "734-416-0152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 SOUTHFIELD RD",
"city": "LINCOLN PARK",
"state": "MI",
"postal_code": "481462250",
"telephone_number": "313-382-8044",
"fax_number": "313-389-3099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IRWIN",
"first_name": "ELIZABETH",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-01-06",
"last_updated": "2010-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901003303",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.