Active NPI
John David Miracle, MS NCC LPC
- Counselor
- Rutherfordton, NC
National Provider Identifier
1154367209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 3647
- Practice address
- 182 West Court St
Rutherfordton, NC 28139 - Phone
- (828) 287-7806
- Fax
- (828) 287-0004
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 3647 | NC | Primary |
Addresses
Primary practice location
182 West Court St
Rutherfordton, NC 28139
Mailing address
PO Box 878
Rutherfordton, NC 28139
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1384E | Other | NC | BCBS |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3647 | NC | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodridge Psychological Assoc PA | Past | Accepting new patients |
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rutherfordton, NC
- NPI 1013951268
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154367209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 878",
"city": "RUTHERFORDTON",
"state": "NC",
"postal_code": "28139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "182 WEST COURT ST",
"city": "RUTHERFORDTON",
"state": "NC",
"postal_code": "28139",
"telephone_number": "828-287-7806",
"fax_number": "828-287-0004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRACLE",
"first_name": "JOHN",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "MS NCC LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NC",
"license": "3647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1384E",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rutherfordton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.