Active NPI
Isabel Theresa Virgille, OD
- Optometrist
- Grand Forks, ND
National Provider Identifier
1700775210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 152W00000X
- Practice address
- Grand Forks Afb
1599 J Street
Grand Forks, ND 58205 - Phone
- (701) 747-5601
- NPI assigned
- Jun 30, 2025
- 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 | 152W00000X | FL | Primary |
Addresses
Primary practice location
Grand Forks Afb
1599 J Street
Grand Forks, ND 58205
Mailing address
1345 NE 201St Ter
Miami, FL 33179-5143
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152W00000X | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751241600000",
"number": "1700775210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1345 NE 201ST TER",
"city": "MIAMI",
"state": "FL",
"postal_code": "331795143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GRAND FORKS AFB",
"address_2": "1599 J STREET",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "58205",
"telephone_number": "701-747-5601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIRGILLE",
"first_name": "ISABEL",
"middle_name": "THERESA",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-30",
"last_updated": "2025-06-30",
"certification_date": "2025-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "152W00000X",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.