Active NPI
Jane Jelicic
- Home Health Agency
- Dallas, TX
National Provider Identifier
1710484548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 14673
- Practice address
- 6243 Bentwood TRL
Dallas, TX 75252-5151 - Phone
- (214) 793-8184
- NPI assigned
- Apr 9, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 14673 | TX | Primary |
Addresses
Primary practice location
6243 Bentwood TRL
Dallas, TX 75252-5151
Mailing address
2350 Airport Fwy Ste 150
Bedford, TX 76022-6050
Phone (817) 508-0030
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14673 | TX | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523232000000",
"number": "1710484548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2350 AIRPORT FWY STE 150",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226050",
"telephone_number": "817-508-0030",
"fax_number": "877-774-5457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6243 BENTWOOD TRL",
"city": "DALLAS",
"state": "TX",
"postal_code": "752525151",
"telephone_number": "214-793-8184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JELICIC",
"first_name": "JANE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-04-09",
"last_updated": "2018-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "14673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.