Individual provider Active NPI

Nikolay Antonov Gospodinov, RMA

  • Nurse's Aide
  • Chandler, AZ
National Provider Identifier
1942004957
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
3041275 Issued in AZ
Practice address
5520 W Chandler Blvd Ste 3
Chandler, AZ 85226-3693
Phone
(602) 362-3974
NPI assigned
Apr 1, 2025
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 3041275 AZ Primary

Addresses

Primary practice location

5520 W Chandler Blvd Ste 3
Chandler, AZ 85226-3693

Mailing address

21021 N 56TH St Apt 3091
Phoenix, AZ 85054-5609
Phone (602) 377-1064

Other practice location 1

9328 E Raintree Dr
Scottsdale, AZ 85260-2098
Phone (602) 362-3974

Other identifiers 1

IdentifierTypeStateIssuer
3041275OtherAZRMA LICENSE

Other names 1

  • Irena Gospodinov Other name

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
Credentials
Registered Medical Assistant

State licenses

LicenseStateTypeSpecialty
3041275AZMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1942004957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21021 N 56TH ST APT 3091",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850545609",
            "telephone_number": "602-377-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5520 W CHANDLER BLVD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852263693",
            "telephone_number": "602-362-3974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9328 E Raintree Dr",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852602098",
            "country_code": "US",
            "telephone_number": "602-362-3974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSPODINOV",
        "first_name": "NIKOLAY",
        "middle_name": "ANTONOV",
        "credential": "RMA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "AZ",
            "license": "3041275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RMA LICENSE",
            "identifier": "3041275",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IRENA",
            "last_name": "GOSPODINOV",
            "credential": "RMA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.