Individual provider Active NPI

Vedrana Jovkovic, APNP

  • Family Nurse Practitioner
  • Kenosha, WI
National Provider Identifier
1174301899
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
14532-33 Issued in WI
Practice address
4006 Washington Rd
Kenosha, WI 53144-4819
Phone
(262) 771-1700
NPI assigned
Sep 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 14532-33 WI Primary

Addresses

Primary practice location

4006 Washington Rd
Kenosha, WI 53144-4819

Mailing address

10640 S Howell Ave
Oak Creek, WI 53154-6310
Phone (515) 321-0108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231205002099 WI Practitioner - Nurse Practitioner 2062861859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Kenosha Community Health Center, Inc.Group PAC ID 0941195168, 19 clinicians

Practice addresses (Care Compare)

4006 Washington Rd
Kenosha, WI 53144-4819
Phone (262) 656-0044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kenosha Community Health Center, Inc. CurrentSince Oct 28, 2023 Accepting new patients
Kenosha Community Health Center, Inc. Current Accepting new patients
Kenosha Community Health Center, Inc CurrentSince Oct 28, 2023 Accepting new patients
Kenosha Community Health Center, Inc Past Accepting new patients

Locations

6226 14th Ave
Kenosha, WI 53143
Phone (262) 656-0044

4006 Washington Rd
Kenosha, WI 53144
Phone (262) 652-4006

4536 22nd Ave
Kenosha, WI 53140
Phone (262) 656-0044

Interoperability endpoints

  • Direct secure messaging: vjovkovic663344@direct.ochin.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1174301899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10640 S HOWELL AVE",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531546310",
            "telephone_number": "515-321-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 WASHINGTON RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531444819",
            "telephone_number": "262-771-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOVKOVIC",
        "first_name": "VEDRANA",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-15",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "14532-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenosha, WI

Sources for this page

Verify at the official NPI Registry.