Individual provider Active NPI

Dejan Miladinovic

  • Registered Nurse
  • Peoria, AZ
National Provider Identifier
1154066793
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN156222 Issued in AZ
Practice address
9224 W John Cabot Rd
Peoria, AZ 85382-7709
Phone
(623) 326-4229
NPI assigned
Apr 28, 2022
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X RN156222 AZ
Infusion Therapy Registered Nurse 163WI0500X RN156222 AZ
Registered Nurse 163W00000X RN156222 AZ Primary

Addresses

Primary practice location

9224 W John Cabot Rd
Peoria, AZ 85382-7709

Mailing address

9224 W John Cabot Rd
Peoria, AZ 85382-7709
Phone (623) 326-4229

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
RN156222AZMDDiabetes Educator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1154066793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9224 W JOHN CABOT RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827709",
            "telephone_number": "623-326-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9224 W JOHN CABOT RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853827709",
            "telephone_number": "623-326-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILADINOVIC",
        "first_name": "DEJAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "AZ",
            "license": "RN156222",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "AZ",
            "license": "RN156222",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN156222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.