Vibrant Integrative Psychiatry PLLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

VIBRANT INTEGRATIVE PSYCHIATRY PLLC

Practice address

6530 Sheridan Rd Ste 3
Kenosha, WI 53143-5063

Phone

(224) 285-6006

NPI assigned

Jan 9, 2023

Last updated

Apr 10, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ilya Melina Ray, APNPNPI 1447639737

Title

Owner

Phone

(224) 285-6006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Vibrant Integrative Psychiatry PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gurnee, IL
  • NPI 1356050769

  7911362033

  Same PAC ID

Tax ID family

Vibrant Integrative Psychiatry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Vibrant Integrative Psychiatry PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gurnee, IL
  • NPI 1356050769
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ilya Melina Ray, F.N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Trevor, WI
  • NPI 1447639737
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681084800000",
    "number": "1962116459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6530 SHERIDAN RD STE 3",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435063",
            "telephone_number": "224-285-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6530 SHERIDAN RD STE 3",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531435063",
            "telephone_number": "224-285-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT INTEGRATIVE PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "ILYA",
        "authorized_official_middle_name": "MELINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "224-285-6006",
        "authorized_official_credential": "APNP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela M Ventura
• Rita R Ventura, APNP
• Becky Verfuerth
• Sachin Verma, D.D.S
• Nisha K Vermani, NP
• Kolya Vice
• Golda Victor
• Tracie Anne Vidas, PTA
• Kirk S Vigil, M.D.
• Village of Somers (Somers Rescue Squad)

• Mental Health Clinic/Center (Including Community Mental Health Center) in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.