Active NPI
Miranda Wright, CPNP
- Pediatric Nurse Practitioner
- Brookhaven, GA
National Provider Identifier
1124592449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- RN248477
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN248477 | GA | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids-Doc-on-Wheels | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Pediatrics Physician
- Clarkston, GA
- NPI 1497277404
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.