Individual provider Active NPI

Milka Granic

  • Day Training/Habilitation Specialist
  • Phoenix, AZ
National Provider Identifier
1235283359
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Day Training/Habilitation SpecialistTaxonomy code 373H00000X
License
10956 Issued in AZ
Practice address
4108 W Stella LN
Phoenix, AZ 85019-1449
Phone
(602) 995-5834
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Day Training/Habilitation Specialist 373H00000X 10956 AZ Primary

Addresses

Primary practice location

4108 W Stella LN
Phoenix, AZ 85019-1449

Mailing address

4108 W Stella LN
Phoenix, AZ 85019-1449
Phone (602) 995-5834

Other identifiers 1

IdentifierTypeStateIssuer
095885MedicaidAZ

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
10956AZMDDay Training/Habilitation Specialist

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1235283359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 W STELLA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850191449",
            "telephone_number": "602-995-5834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4108 W STELLA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850191449",
            "telephone_number": "602-995-5834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANIC",
        "first_name": "MILKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": "AZ",
            "license": "10956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095885",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.