Active NPI
Manda Maria Radulovic
- Registered Dietitian
- Tempe, AZ
National Provider Identifier
1134811011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 86326199
- Practice address
- 950 W Elliot Rd
Tempe, AZ 85284-1144 - Phone
- (602) 300-7949
- NPI assigned
- May 22, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86326199 | AZ | Primary |
Addresses
Primary practice location
950 W Elliot Rd
Tempe, AZ 85284-1144
Mailing address
9010 S Priest Dr Apt 3208
Tempe, AZ 85284-1194
Phone (602) 300-7949
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Turnwell Mental Health of Arizona, PC | Current | Accepting new patients | |
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
Locations
8350 E Raintree Dr
Ste 130
Scottsdale, AZ 85260
Phone (480) 508-0882
1492 S Mill Ave
Ste 206
Tempe, AZ 85281
Phone (480) 508-0882
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Psychiatry Physician
- Scottsdale, AZ
- NPI 1639872518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1134811011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9010 S PRIEST DR APT 3208",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841194",
"telephone_number": "602-300-7949"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 W ELLIOT RD",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841144",
"telephone_number": "602-300-7949"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADULOVIC",
"first_name": "MANDA",
"middle_name": "MARIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-22",
"certification_date": "2023-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "AZ",
"license": "86326199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.