Active NPI
Floraeden Yerkovich
- Nursing Home Administrator
- Mesa, AZ
National Provider Identifier
1346867231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- License
- AL1859
- Practice address
- 2102 N Chestnut Cir
Mesa, AZ 85213-2216 - Phone
- (480) 668-8324
- Fax
- (480) 668-8328
- NPI assigned
- Jun 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | AL1859 | AZ | Primary |
Addresses
Primary practice location
2102 N Chestnut Cir
Mesa, AZ 85213-2216
Mailing address
2102 N Chestnut Cir
Mesa, AZ 85213-2216
Phone (480) 668-8324
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
| License | State | Type | Specialty |
|---|---|---|---|
| AL1859 | AZ | MD | Nursing Home Administrator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593129600000",
"number": "1346867231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2102 N CHESTNUT CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852132216",
"telephone_number": "480-668-8324",
"fax_number": "480-668-8328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2102 N CHESTNUT CIR",
"city": "MESA",
"state": "AZ",
"postal_code": "852132216",
"telephone_number": "480-668-8324",
"fax_number": "480-668-8328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YERKOVICH",
"first_name": "FLORAEDEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-26",
"last_updated": "2020-06-26",
"certification_date": "2020-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "AZ",
"license": "AL1859",
"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 Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.