Individual provider Active NPI

Branko Miljkovic

  • Athletic Trainer
  • Iowa City, IA
National Provider Identifier
1497265284
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
1164 Manitou TRL
Iowa City, IA 52245-2704
Phone
(319) 512-8383
NPI assigned
Oct 5, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X IA
Athletic Trainer 2255A2300X Primary

Addresses

Primary practice location

1164 Manitou TRL
Iowa City, IA 52245-2704

Mailing address

1164 Manitou TRL
Iowa City, IA 52245-2704
Phone (319) 512-8383

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

NPI Registry JSON

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1497265284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1164 MANITOU TRL",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452704",
            "telephone_number": "319-512-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1164 MANITOU TRL",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522452704",
            "telephone_number": "319-512-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILJKOVIC",
        "first_name": "BRANKO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IA",
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.