Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1952521874 Individual Practitioner Male Practitioner

Dr. Michael Eric Ivory , DO

General Practice • Gallup, NM

Professional Overview & Biography Verified Profile Summary

Dr. Michael Ivory, DO is a registered healthcare professional specializing in General Practice in Gallup, NM. Practice services are available at 516 E. NIZHONI BLVD. under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

516 E. Nizhoni Blvd.

Gallup, NM 873011337

Telephone 5057221000
Fax 5057268740
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Gallup, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 39.5 Yrs
State Avg: 32.0 Yrs
Regional Practice Density
6 Specialists

Practicing in Gallup, NM (115 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License MI 5101007170

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
30010400 (WI)
Medicaid State Provider ID
4709700 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Johanna Palmgren

Registered Nurse - Administrator

NPI 1003001314
Sandra Skeets , RN

Registered Nurse - Ambulatory Care

NPI 1003009945

Registered Nurse

Jennifer Moore , RN, BSN

Registered Nurse - Medical-Surgical

NPI 1003016460

Registered Nurse, Bachelor of Science in Nursing

Sally Kaufman , RN

Registered Nurse

NPI 1003110537

Registered Nurse

Nancy Davis , RN

Registered Nurse

NPI 1003184201

Registered Nurse

Lorraine Cabrillas , RN

Registered Nurse - Emergency

NPI 1003372004

Registered Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 27, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location September 27, 2012

Registered at 516 E. NIZHONI BLVD., GALLUP, NM 873011337 (Tel: 5057221000)

📍
Updated Business Mailing Address September 27, 2012

Registered at 4070 N CHIPMAN ST, OWOSSO, MI 488679444 (Tel: 9897235236)

👤
Provider Name / Credentials Updated September 27, 2012

Recorded as MICHAEL IVORY, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 27, 2012

General Practice (License #5101007170 in MI)

🟢
Initial NPI Registration & Enumeration April 26, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1952521874
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 26, 2007
Last Update: September 27, 2012
Sole Proprietor: No

Mailing Address

4070 N Chipman St

Owosso, MI 488679444

Phone: 9897235236

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.