Individual provider Active NPI

Branka Danicic

  • Pharmacist
  • Merrillville, IN
National Provider Identifier
1396326013
Registry record updated Apr 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
26028567A Issued in IN
Practice address
1310 E 79TH Ave
Merrillville, IN 46410-5768
Phone
(219) 641-6402
Fax
(219) 641-6421
NPI assigned
Apr 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 26028567A IN Primary

Addresses

Primary practice location

1310 E 79TH Ave
Merrillville, IN 46410-5768

Mailing address

1310 E 79TH Ave
Merrillville, IN 46410-5768
Phone (219) 641-6402

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL NA

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
26028567AINMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1396326013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 E 79TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105768",
            "telephone_number": "219-641-6402",
            "fax_number": "219-641-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 E 79TH AVE",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105768",
            "telephone_number": "219-641-6402",
            "fax_number": "219-641-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANICIC",
        "first_name": "BRANKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IN",
            "license": "26028567A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "NA",
            "affiliation": "N",
            "address_1": "1310 E 79th Ave",
            "city": "Merrillville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "464105768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Merrillville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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.