Individual provider Active NPI

Mirian Langer

  • Gerontology Nurse Practitioner
  • Daytona Beach, FL
National Provider Identifier
1174975908
Registry record updated Feb 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
9278406 Issued in FL
Practice address
731 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603
Phone
(386) 257-1626
Fax
(866) 486-1253
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 9278406 FL Primary

Addresses

Primary practice location

731 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603

Mailing address

6101 Blue Lagoon Dr Ste 200
Miami, FL 33126-3168
Phone (305) 500-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mirian.langer.1@29601.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20161201002012 FL Practitioner - Nurse Practitioner 9830479104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conviva Medical Center Management, LLCGroup PAC ID 4284717422, 507 clinicians

Practice addresses (Care Compare)

731 N Clyde Morris Blvd
Daytona Beach, FL 32114-1603
Phone (386) 257-1626

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Daytona Beach, FL, CCN 107338
  • AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9278406FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Conviva Medical Center Management LLC CurrentSince Jun 23, 2025 Accepting new patients

Locations

731 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 257-1626

5238 Norwood Ave
#16
Jacksonville, FL 32208
Phone (904) 265-2050

4960 SW 72nd Ave
Ste 406
Miami, FL 33155

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

Interoperability endpoints

  • Direct secure messaging: mirian.langer.1@29601.direct.athenahealth.com
  • Direct secure messaging: mirian.langer.1@15445.direct.athenahealth.com
  • Direct secure messaging: ardentfamilycare.mirianlanger@159757.advancedmd-direct.com

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.

Hospital & facility affiliations 2

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771286400000",
    "number": "1174975908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "305-500-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141603",
            "telephone_number": "386-257-1626",
            "fax_number": "866-486-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGER",
        "first_name": "MIRIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2026-02-17",
        "certification_date": "2026-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "9278406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mirian.langer.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "731 N Clyde Morris Blvd",
            "city": "Daytona Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321141603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.