Individual provider Active NPI

Miranda Wright, CPNP

  • Pediatric Nurse Practitioner
  • Brookhaven, GA
National Provider Identifier
1124592449
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN248477 Issued in GA
Practice address
1575 Northeast Expy NE
Brookhaven, GA 30329-2317
Phone
(404) 785-5437
NPI assigned
Jan 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN248477 GA
Pediatric Nurse Practitioner 363LP0200X RN248477 GA Primary

Addresses

Primary practice location

1575 Northeast Expy NE
Brookhaven, GA 30329-2317

Mailing address

1438 McLendon Dr
Decatur, GA 30033-1802
Phone (770) 876-7923

Other practice location 1

4112 E Ponce De Leon Ave Ste 2
Clarkston, GA 30021-8106
Phone (404) 574-2512

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
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN248477GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kids-Doc-on-Wheels Pediatrics Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IADFDD/Endpoint/IADFDD

Organizations & group practices 1

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": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1124592449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1438 MCLENDON DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331802",
            "telephone_number": "770-876-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 NORTHEAST EXPY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292317",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 E Ponce De Leon Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Clarkston",
            "state": "GA",
            "postal_code": "300218106",
            "country_code": "US",
            "telephone_number": "404-574-2512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "MIRANDA",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-21",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN248477",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN248477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.