Active NPI
Shawn Hamilton Miranda, PA-C
- Physician Assistant
- Whiteman Air Force Base, MO
National Provider Identifier
1194235879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 331 Sijen Ave
Whiteman Air Force Base, MO 65305-1269 - Phone
- (660) 687-7187
- NPI assigned
- Oct 6, 2017
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
331 Sijen Ave
Whiteman Air Force Base, MO 65305-1269
Mailing address
4881 Sugar Maple Dr
Dayton, OH 45433-5529
Phone (937) 522-4289
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191022002763 | OH | Order and Referring Only - Physician Assistant | 4981936085 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745452800000",
"number": "1194235879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454335529",
"telephone_number": "937-522-4289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "331 SIJEN AVE",
"city": "WHITEMAN AIR FORCE BASE",
"state": "MO",
"postal_code": "653051269",
"telephone_number": "660-687-7187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "SHAWN",
"middle_name": "HAMILTON",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-06",
"last_updated": "2025-04-24",
"certification_date": "2025-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiteman Air Force Base, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.