Individual provider Active NPI

Jelena Zivanovic

  • Developmental Disabilities Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1528424603
Registry record updated Jun 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Practice address
2894 52ND LN N
Saint Petersburg, FL 33710-3441
Phone
(727) 249-6845
NPI assigned
Jan 5, 2016
Last updated
Jun 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU Primary

Addresses

Primary practice location

2894 52ND LN N
Saint Petersburg, FL 33710-3441

Mailing address

2894 52ND LN N
Saint Petersburg, FL 33710-3441
Phone (727) 249-6845

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine State Living, Inc. Developmental Disabilities Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496620800000",
    "number": "1528424603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2894 52ND LN N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337103441",
            "telephone_number": "727-249-6845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2894 52ND LN N",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337103441",
            "telephone_number": "727-249-6845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIVANOVIC",
        "first_name": "JELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-05",
        "last_updated": "2017-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

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