Active NPI
Jelena Dinic, CRNP
- Family Nurse Practitioner
- Allentown, PA
National Provider Identifier
1720072614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- VP006565B
- Practice address
- 17TH & Chew St
Allentown, PA 18102 - Phone
- (610) 402-9099
- Fax
- (610) 402-9029
- NPI assigned
- Sep 7, 2005
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | VP006565B | PA | Primary |
| Registered Nurse | 163W00000X | RN247091L | PA |
Addresses
Primary practice location
17TH & Chew St
Allentown, PA 18102
Mailing address
1245 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6258
Phone (610) 402-9099
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03211501 | Other | PA | CAPITAL ADVANTAGE |
| 1389298 | Other | PA | KEYSTONE CENTRAL |
| 1389298 | Other | PA | HIGHMARK |
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
- Certified Registered Nurse, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN247091L | PA | MD | Registered Nurse |
| VP006565B | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1321228800000",
"number": "1720072614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 S CEDAR CREST BLVD",
"address_2": "SUITE 301",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036258",
"telephone_number": "610-402-9099",
"fax_number": "610-402-9029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17TH & CHEW ST",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "18102",
"telephone_number": "610-402-9099",
"fax_number": "610-402-9029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINIC",
"first_name": "JELENA",
"name_prefix": "Ms.",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-07",
"last_updated": "2011-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "VP006565B",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN247091L",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL ADVANTAGE",
"identifier": "03211501",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE CENTRAL",
"identifier": "1389298",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK",
"identifier": "1389298",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.