Active NPI
Lorraine Michelle Ivey
- Children's Substance Abuse Rehabilitation Facility
- Washington, UT
National Provider Identifier
1952790099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Children's Substance Abuse Rehabilitation Facility
- Practice address
- 115 N 200 E
Washington, UT 84780-1642 - Phone
- (435) 669-8981
- NPI assigned
- Jan 13, 2015
- Last updated
- Jan 13, 2015
- 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 |
|---|---|---|---|---|
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X | UT | Primary |
Addresses
Primary practice location
115 N 200 E
Washington, UT 84780-1642
Mailing address
115 N 200 E
Washington, UT 84780-1642
Phone (435) 669-8981
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 901207545-04 | Other | UT | ALTIUS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421107200000",
"number": "1952790099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 N 200 E",
"city": "WASHINGTON",
"state": "UT",
"postal_code": "847801642",
"telephone_number": "435-669-8981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 N 200 E",
"city": "WASHINGTON",
"state": "UT",
"postal_code": "847801642",
"telephone_number": "435-669-8981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVEY",
"first_name": "LORRAINE",
"middle_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-13",
"last_updated": "2015-01-13",
"status": "A"
},
"taxonomies": [
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": "UT",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "901207545-04",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.