NPIMap

Individual provider Active NPI

Peter J. Milanovich, DC, LPT

  • Chiropractor
  • Lake Oswego, OR
National Provider Identifier
1992767248
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
27-1590 Issued in OR
Practice address
16679 SW Boones Ferry Rd.
Suite 105
Lake Oswego, OR 97035-4378
Phone
(503) 635-6005
Fax
(503) 635-6016
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 27-1590 OR Primary
Physical Therapist 225100000X 0564 OR

Addresses

Primary practice location

16679 SW Boones Ferry Rd.
Suite 105
Lake Oswego, OR 97035-4378

Mailing address

16679 SW Boones Ferry Rd.
Suite 105
Lake Oswego, OR 97035-4378
Phone (503) 635-6005

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

State licenses

LicenseStateTypeSpecialty
0564ORMDClinical Psychologist
27-1590ORMDChiropractor
1590ORMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1992767248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16679 SW BOONES FERRY RD.",
            "address_2": "SUITE 105",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354378",
            "telephone_number": "503-635-6005",
            "fax_number": "503-635-6016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16679 SW BOONES FERRY RD.",
            "address_2": "SUITE 105",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970354378",
            "telephone_number": "503-635-6005",
            "fax_number": "503-635-6016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILANOVICH",
        "first_name": "PETER",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DC, LPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "27-1590",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "0564",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Oswego, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.