Andrea Kay Irving, D.O.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

005207 Issued in AZ

Practice address

19251 E Oasis Dr
Black Canyon City, AZ 85324-8878

Phone

(623) 374-0200

NPI assigned

Apr 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Dr. Andrea Kay Hutchison Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1780858878",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "164 AUGUST LILY CRESCENT",
            "city": "GLOUCESTER",
            "state": "ON",
            "postal_code": "K1V 2E3"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 E OASIS DR",
            "city": "BLACK CANYON CITY",
            "state": "AZ",
            "postal_code": "853248878",
            "telephone_number": "623-374-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVING",
        "first_name": "ANDREA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AZ",
            "license": "R1055",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "AZ",
            "license": "005207",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "005207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE LICENSE NUMBER",
            "identifier": "005207",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAINING PERMIT",
            "identifier": "R1055",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "notapplicable",
            "affiliation": "N",
            "endpointDescription": "notapplicable",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "notapplicable",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "notapplicable",
            "address_1": "164 August Lily Crescent",
            "city": "Gloucester",
            "state": "ON",
            "country_code": "CA",
            "postal_code": "K1V 2E3",
            "country_name": "Canada",
            "address_type": "FGN"
        }
    ],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "HUTCHISON",
            "middle_name": "KAY",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• General Practice Physician in Black Canyon City, AZ
• Providers in Black Canyon City, AZ by specialty
• General Practice Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.

Verify at the official NPI Registry.