Individual provider Active NPI

Mira Lelovic, DPT

  • Physical Therapist
  • Little Rock, AR
National Provider Identifier
1659520864
Registry record updated May 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3091 Issued in AR
Practice address
4300 W 7TH St
Little Rock, AR 72205-5446
Phone
(501) 257-6414
NPI assigned
Sep 11, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3091 AR Primary

Addresses

Primary practice location

4300 W 7TH St
Little Rock, AR 72205-5446

Mailing address

1712 Sawgrass Dr
Little Rock, AR 72212-2698
Phone (501) 952-2088

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

State licenses

LicenseStateTypeSpecialty
3091ARMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399075200000",
    "number": "1659520864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 SAWGRASS DR",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722122698",
            "telephone_number": "501-952-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 W 7TH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722055446",
            "telephone_number": "501-257-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LELOVIC",
        "first_name": "MIRA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2014-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "3091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2014; 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.