Individual provider Active NPI

Miranda Gill

  • Marriage & Family Therapist
  • Lexington, KY
National Provider Identifier
1073167706
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
294359 Issued in KY
Practice address
1255 Providence Place Pkwy Ste 115
Lexington, KY 40511-8379
Phone
(216) 468-5000
NPI assigned
Jul 31, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 294359 KY Primary

Addresses

Primary practice location

1255 Providence Place Pkwy Ste 115
Lexington, KY 40511-8379

Mailing address

102 River Dr
Irvine, KY 40336-1118
Phone (606) 717-1024

Other practice location 1

110 River Dr
Irvine, KY 40336-1118
Phone (606) 717-1024

Other practice location 2

1351 Newtown Pike
Lexington, KY 40511-1275
Phone (859) 253-1686

Other identifiers 1

IdentifierTypeStateIssuer
1790731081MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250212002853 KY Practitioner - Marriage and Family Therapist 7113454851 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychological and Behavioral Consultants LLCGroup PAC ID 0446243760, 595 clinicians

Practice addresses (Care Compare)

1255 Providence LN
Suite 115
Lexington, KY 40502-2380
Phone (216) 468-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
294359KYMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health Group, LLC Marriage & Family Therapist CurrentSince Jan 29, 2025 Accepting new patients
Psychological & Behavioral Consultants, LLC CurrentSince Sep 15, 2025 Accepting new patients
Endeavor Health, PLLC CurrentSince Jan 21, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients

Locations

102 River Dr
Irvine, KY 40336
Phone (606) 614-8081

110 River Dr
Irvine, KY 40336
Phone (606) 717-1024

1255 Providence Place Pkwy
Ste 115
Lexington, KY 40511
Phone (859) 214-7440

312 S 4th St
Louisville, KY 40202
Phone (502) 213-5590

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 313-6880

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1073167706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 RIVER DR",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403361118",
            "telephone_number": "606-717-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 PROVIDENCE PLACE PKWY STE 115",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405118379",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 River Dr",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "KY",
            "postal_code": "403361118",
            "country_code": "US",
            "telephone_number": "606-717-1024",
            "fax_number": "606-717-1048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1351 Newtown Pike",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405111275",
            "country_code": "US",
            "telephone_number": "859-253-1686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "MIRANDA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "294359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790731081",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.