NPIMap

Individual provider Active NPI

Dejan Lukovic, ACNP

  • Acute Care Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1427545854
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
21836 Issued in SC
Practice address
203 Mills Ave
Greenville, SC 29605-4019
Phone
(864) 271-1844
NPI assigned
Apr 20, 2018
Last updated
Apr 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 21836 SC Primary

Addresses

Primary practice location

203 Mills Ave
Greenville, SC 29605-4019

Mailing address

203 Mills Ave
Greenville, SC 29605-4019
Phone (864) 271-1844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180611002384 SC Practitioner - Nurse Practitioner 4082969266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Nephrology PAGroup PAC ID 2961467733, 37 clinicians

Practice addresses (Care Compare)

400 Plaza Cir
Suite H
Clinton, SC 29325-7558
Phone (864) 271-1844

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Nephrology PA CurrentSince May 1, 2018 Accepting new patients
Carolina ASC LLC PastSince May 1, 2024 Accepting new patients

Locations

455 E Whitner St
Anderson, SC 29624
Phone (864) 759-0314

803 N Fant St
Ste 2A
Anderson, SC 29621
Phone (864) 225-7401

400 Plaza Cir
Ste H
Clinton, SC 29325
Phone (864) 833-4166

121 Commerce Blvd
Ste B
Easley, SC 29642
Phone (864) 859-3038

406 Tiffany Park
#B
Gaffney, SC 29341
Phone (864) 663-2736

110 Chalmers Rd
Unit A
Greenville, SC 29605
Phone (864) 977-8200

110 Chalmers Rd
Unit B
Greenville, SC 29605

203 Mills Ave
Greenville, SC 29605
Phone (803) 271-1844

108 W Church St
Greer, SC 29650
Phone (864) 801-9736

45 Aaron Tippin Dr
Greer, SC 29650
Phone (864) 848-5555

110B Hospital Dr
Simpsonville, SC 29681
Phone (864) 382-6940

1410 John B White SR Blvd
Spartanburg, SC 29306
Phone (864) 574-0017

Interoperability endpoints

  • Direct secure messaging: dlukovic229826@direct.ghs.myhfn.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 45

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1427545854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054019",
            "telephone_number": "864-271-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 MILLS AVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054019",
            "telephone_number": "864-271-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKOVIC",
        "first_name": "DEJAN",
        "name_prefix": "Mr.",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-20",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "21836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.