NPIMap

Organization Active NPI

Stevanovic Clinics SC

Doing business as Stevanovic Family Clinic

  • Primary Care Clinic/Center
  • West Allis, WI
National Provider Identifier
1508830076
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
39372 Issued in WI
Legal business name
STEVANOVIC CLINICS SC
Doing business as
Stevanovic Family Clinic
Practice address
11111 W Oklahoma Ave
West Allis, WI 53227-4033
Phone
(414) 546-8000
Fax
(414) 546-2909
NPI assigned
Feb 14, 2006
Last updated
Jul 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

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

Authorized official

Name
Dr. Nebojsa Stevanovic, MDNPI 1255494233
Title
MD
Phone
(414) 546-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 39372 WI Primary
Durable Medical Equipment & Medical Supplies 332B00000X 39372 WI

Addresses

Primary practice location

11111 W Oklahoma Ave
West Allis, WI 53227-4033

Mailing address

11111 W Oklahoma Ave
West Allis, WI 53227-4033
Phone (414) 546-8000

Other identifiers 2

IdentifierTypeStateIssuer
32398100MedicaidWI
000001299OtherWIPTAN

Other names 1

  • Stevanovic Family Clinic Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
52D1037628Stevanovic Family Clinic11111 W Oklahoma Ave, West Allis, WI 53227AccreditationJul 19, 2027

National Provider Directory

National Provider Directory

Locations

308 E Main St
Waterford, WI 53185
Phone (262) 923-3777

11111 W Oklahoma Ave
West Allis, WI 53227
Phone (414) 546-8000

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374105600000",
    "number": "1508830076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11111 W OKLAHOMA AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532274033",
            "telephone_number": "414-546-8000",
            "fax_number": "414-546-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 W OKLAHOMA AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532274033",
            "telephone_number": "414-546-8000",
            "fax_number": "414-546-2909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVANOVIC CLINICS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2013-07-18",
        "status": "A",
        "authorized_official_last_name": "STEVANOVIC",
        "authorized_official_first_name": "NEBOJSA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "414-546-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WI",
            "license": "39372",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "WI",
            "license": "39372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32398100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "000001299",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stevanovic Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.