Active NPI
Miranda Fugate, LPN
- Licensed Practical Nurse
- Cincinnati, OH
National Provider Identifier
1083321376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 163278
- Practice address
- 830 Ezzard Charles Dr
Cincinnati, OH 45214-2525 - Phone
- (513) 381-6672
- NPI assigned
- Nov 4, 2022
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 163278 | OH | Primary |
Addresses
Primary practice location
830 Ezzard Charles Dr
Cincinnati, OH 45214-2525
Mailing address
7246 Creekview Dr Apt 9
Cincinnati, OH 45247-3025
Phone (513) 335-8121
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | n/a |
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 |
|---|---|---|---|
| 163278 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667520000000",
"number": "1083321376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7246 CREEKVIEW DR APT 9",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452473025",
"telephone_number": "513-335-8121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 EZZARD CHARLES DR",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452142525",
"telephone_number": "513-381-6672"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUGATE",
"first_name": "MIRANDA",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-04",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "163278",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "n/a",
"affiliation": "N",
"address_1": "830 Ezzard Charles Dr",
"city": "Cincinnati",
"state": "OH",
"country_code": "US",
"postal_code": "452142525",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.