Individual provider Active NPI

Perrie Vanpembrook

  • Registered Nurse
  • Iron Mountain, MI
National Provider Identifier
1790493443
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704167215 Issued in MI
Practice address
1115 S Hemlock St Ste 1
Iron Mountain, MI 49801-3800
Phone
(906) 774-2561
NPI assigned
Nov 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704167215 MI Primary

Addresses

Primary practice location

1115 S Hemlock St Ste 1
Iron Mountain, MI 49801-3800

Mailing address

97 S 4TH St Ste C
Ishpeming, MI 49849-2168
Phone (906) 228-9699

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

LicenseStateTypeSpecialty
4704167215MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1668124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1790493443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 S 4TH ST STE C",
            "city": "ISHPEMING",
            "state": "MI",
            "postal_code": "498492168",
            "telephone_number": "906-228-9699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 S HEMLOCK ST STE 1",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013800",
            "telephone_number": "906-774-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANPEMBROOK",
        "first_name": "PERRIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-11",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704167215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iron Mountain, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; 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.