Miracle 3D Moments, LLC

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

Legal business name

MIRACLE 3D MOMENTS, LLC

Practice address

22 Wilson Ave NE Ste 201
Saint Cloud, MN 56304-0418

Phone

(320) 208-6064

Fax

(833) 938-4654

NPI assigned

Jan 3, 2023

Organization subpart

Yes

Parent organization

MIRACLE 3D MOMENTS, LLCAs reported in NPPES

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

Authorized official

Name

Mrs. Crystal Ann Heller, RDMS

Title

Owner/ Sonographer

Phone

(320) 245-7701

Specialties & licenses 1

Addresses

Other names 1

• Choice Ultrasound Doing business as

Part of

Miracle 3D Moments LLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1184337263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8182 PARADISE BEACH RD",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564011864",
            "telephone_number": "320-761-5062",
            "fax_number": "833-938-4654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WILSON AVE NE STE 201",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563040418",
            "telephone_number": "320-208-6064",
            "fax_number": "833-938-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE 3D MOMENTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIRACLE 3D MOMENTS, LLC",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/ SONOGRAPHER",
        "authorized_official_telephone_number": "320-245-7701",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choice Ultrasound",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meghan Lyn Minor
• Peter Minor
• Minser Chiropractic Clinic, P.a., Inc.
• Mary Beth Minser, D.C.
• Alishia Minzel
• John D Mischke, MD
• Joseph James Miskulin, M.D.
• Lee Ann Misstishin, PA-C
• Paul J Mitchell, MD
• Melissa Ann Mitzel

• Diagnostic Ultrasound Physician in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Diagnostic Ultrasound Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.