Elisa Miranda Sison Irisari, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

11087 Issued in WV

Practice address

119 Jefferson Ave
Moundsville, WV 26041-1410

Phone

(304) 845-8555

Fax

(304) 843-1008

NPI assigned

Oct 26, 2006

Last updated

Oct 28, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Elisa Sison Irisani Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1770668816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 EOFF ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033823",
            "telephone_number": "304-234-8663",
            "fax_number": "304-234-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 JEFFERSON AVE",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260411410",
            "telephone_number": "304-845-8555",
            "fax_number": "304-843-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISON IRISARI",
        "first_name": "ELISA",
        "middle_name": "MIRANDA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WV",
            "license": "11087",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OH",
            "license": "0108761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094259000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISA",
            "last_name": "SISON IRISANI",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shabnam Saeed Sherazi
• Cathy Shively
• David Simmons
• Sierra Danielle Simmons
• Kelly Simms
• Lillian Elizabeth Smallwood
• Kendra Brielle Smertneck
• Carey L Smith
• Chelsey M Smith
• Christine Smith

• Obstetrics & Gynecology Physician in Moundsville, WV
• Providers in Moundsville, WV by specialty
• Obstetrics & Gynecology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; 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.