Tomislav M. Jelic, MD

Primary specialty

Anatomic Pathology PhysicianTaxonomy code 207ZP0101X

License

17984 Issued in WV

Practice address

3200 Maccorkle Avenue SE
Pathology Department
Charleston, WV 25304

Phone

(304) 388-5550

Fax

(304) 388-4352

NPI assigned

Jun 23, 2006

Last updated

Jul 15, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279152000000",
    "number": "1609802511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MORRIS STREET",
            "address_2": "SUITE 304",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25301",
            "telephone_number": "304-388-7782",
            "fax_number": "304-388-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 MACCORKLE AVENUE SE",
            "address_2": "PATHOLOGY DEPARTMENT",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "25304",
            "telephone_number": "304-388-5550",
            "fax_number": "304-388-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELIC",
        "first_name": "TOMISLAV",
        "middle_name": "M.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2010-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "WV",
            "license": "17984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aalayah Jeffries
• Angela Jeffries
• Angela Hope Jeffries, CRNA
• Jacia Jeffries
• Kiara Jeffries
• Alaina Jenkins
• Andrew Michael Jenkins, CRNA
• Ashley Jenkins
• Christine Jenkins
• Courtney Renae Jenkins, CRNA

• Anatomic Pathology Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Anatomic Pathology Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.