Individual provider Active NPI

Miranda Day, NP

  • Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1124560487
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
21145 Issued in TN
Practice address
818 Sunset Dr
Ste. 102
Johnson City, TN 37604-8310
Phone
(423) 794-3142
Fax
(865) 330-6323
NPI assigned
Nov 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21145 TN Primary

Addresses

Primary practice location

818 Sunset Dr
Ste. 102
Johnson City, TN 37604-8310

Mailing address

102 Lee Carter Dr
Johnson City, TN 37601-3094
Phone (865) 330-6320

Other identifiers 1

IdentifierTypeStateIssuer
4972149OtherTNCIGNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170130002708 TN Practitioner - Nurse Practitioner 7416239215 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21145TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CS Pacs 3 Southeast, LLC CurrentSince Jul 12, 2024 Accepting new patients
NV Pacs 2 LLC CurrentSince Aug 11, 2021 Accepting new patients
Ipc Pac Healthcare Services of Tennessee PC Nurse Practitioner CurrentSince May 24, 2021 Accepting new patients
Associated Pain Specialists, PC Past Accepting new patients
Priority Anesthesia, LLC Past Accepting new patients

Locations

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

Organizations & group practices 6

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": "1479340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482278400000",
    "number": "1124560487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 LEE CARTER DR",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376013094",
            "telephone_number": "865-330-6320",
            "fax_number": "865-330-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 SUNSET DR",
            "address_2": "STE. 102",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048310",
            "telephone_number": "423-794-3142",
            "fax_number": "865-330-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAY",
        "first_name": "MIRANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-17",
        "last_updated": "2016-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "21145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4972149",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.