Active NPI
Devi Jayanthi Mikkilineni, MD
- Psychiatry Physician
- Des Moines, IA
National Provider Identifier
1689845554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 29038
- Practice address
- 1301 Pennsylvania Ave
Suite 408
Des Moines, IA 50316-2350 - Phone
- (515) 263-5000
- Fax
- (515) 263-5001
- NPI assigned
- Mar 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 29038 | IA | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 29038 | IA |
Addresses
Primary practice location
1301 Pennsylvania Ave
Suite 408
Des Moines, IA 50316-2350
Mailing address
1301 Pennsylvania Ave
Suite 408
Des Moines, IA 50316-2350
Phone (515) 263-5000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689845554 | Medicaid | IA | |
| 29038 | Other | IA | LICENSE |
| P00821968 | Other | IA | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29038 | IA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320278400000",
"number": "1689845554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 PENNSYLVANIA AVE",
"address_2": "SUITE 408",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503162350",
"telephone_number": "515-263-5000",
"fax_number": "515-263-5001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 PENNSYLVANIA AVE",
"address_2": "SUITE 408",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503162350",
"telephone_number": "515-263-5000",
"fax_number": "515-263-5001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIKKILINENI",
"first_name": "DEVI",
"middle_name": "JAYANTHI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-18",
"last_updated": "2011-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IA",
"license": "29038",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "IA",
"license": "29038",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1689845554",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "29038",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00821968",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
- Midwest Medical Transport Company, LLC Dba Fraser Transportation Servi
- Midwest Mobility Solutions Inc.
- Midwest Podiatry Associates, P.C.
- Andrew Robert Miesner, PHARMD, BCPS
- Bonnie Mikelson, LISW
- Daniela Milani, MD
- Jennifer June Milby, FNP-C
- Linley Mild
- Milestones Psychiatry PC
- Dinka Miljkovic, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.