Individual provider Active NPI

Amie Jill Irving

  • Specialist
  • Groveland, IL
National Provider Identifier
1932359916
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
041.370335 Issued in IL
Practice address
479 Bessler Lake Dr
Groveland, IL 61535-9710
Phone
(309) 387-2023
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 041.370335 IL Primary

Addresses

Primary practice location

479 Bessler Lake Dr
Groveland, IL 61535-9710

Mailing address

479 Bessler Lake Dr
Groveland, IL 61535-9710
Phone (309) 387-2023

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
041.370335ILMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1932359916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 BESSLER LAKE DR",
            "city": "GROVELAND",
            "state": "IL",
            "postal_code": "615359710",
            "telephone_number": "309-387-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 BESSLER LAKE DR",
            "city": "GROVELAND",
            "state": "IL",
            "postal_code": "615359710",
            "telephone_number": "309-387-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVING",
        "first_name": "AMIE",
        "middle_name": "JILL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "041.370335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groveland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.