NPIMap

Individual provider Active NPI

Miranda Ann Gardner, FNP-C

  • Family Nurse Practitioner
  • Liberty, IN
National Provider Identifier
1114406568
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71008209A Issued in IN
Practice address
950 N Market St
Liberty, IN 47353-8496
Phone
(765) 458-5191
Fax
(765) 458-7301
NPI assigned
Aug 7, 2018
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71008209A IN Primary

Addresses

Primary practice location

950 N Market St
Liberty, IN 47353-8496

Mailing address

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 458-5191

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgardner299574@ReidHealth.direct-ci.com Reid Physician Associates, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181017003518 IN Practitioner - Nurse Practitioner 4981956034 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians
Neighborhood Health Center, Inc.Group PAC ID 6608139621, 11 clinicians

Practice addresses (Care Compare)

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3122

950 N Market St
Union County Medical Center
Liberty, IN 47353-8496
Phone (765) 458-5191

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reid Physician Associates, Inc. CurrentSince Feb 24, 2019 Accepting new patients
Reid Physician Associates, Inc CurrentSince Feb 24, 2019 Accepting new patients
Neighborhood Health Center CurrentSince Jun 1, 2021 Accepting new patients
Neighborhood Health Center, Inc. CurrentSince Jun 1, 2021 Accepting new patients
Neighborhood Health Center, Inc. Family Current Accepting new patients
Union County Medical Center Inc Past Accepting new patients
Major Hospital Past Accepting new patients

Locations

950 N Market St
Liberty, IN 47353
Phone (765) 458-5191

101 S 10th St
Richmond, IN 47374
Phone (765) 965-4299

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21036/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mgardner299574@reidhealth.direct-ci.com
  • Direct secure messaging: mgardner340605@direct.ochin.org

Organizations & group practices 7

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1114406568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-458-5191",
            "fax_number": "765-458-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N MARKET ST",
            "city": "LIBERTY",
            "state": "IN",
            "postal_code": "473538496",
            "telephone_number": "765-458-5191",
            "fax_number": "765-458-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "MIRANDA",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008209A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgardner299574@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Reid Physician Associates, Inc.",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Liberty, IN

Sources for this page

Verify at the official NPI Registry.