Individual provider Active NPI

Elizabeth Jane Nikolic, NMD

  • Naturopath
  • Mesa, AZ
National Provider Identifier
1346525821
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
NaturopathTaxonomy code 175F00000X
License
11-1233 Issued in AZ
Practice address
4140 E Baseline Rd Ste 110
Mesa, AZ 85206-4413
Phone
(480) 539-0777
NPI assigned
Oct 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Naturopath 175F00000X 11-1233 AZ Primary

Addresses

Primary practice location

4140 E Baseline Rd Ste 110
Mesa, AZ 85206-4413

Mailing address

4140 E Baseline Rd Ste 110
Mesa, AZ 85206-4413
Phone (480) 539-0777

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
11-1233AZMDNaturopath

NPI Registry JSON

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318809600000",
    "number": "1346525821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-539-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 E BASELINE RD STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064413",
            "telephone_number": "480-539-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIKOLIC",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "NMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "AZ",
            "license": "11-1233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.