Individual provider Active NPI

Miranda Alexander Bazemore, FNP-C

  • Family Nurse Practitioner
  • Castle Rock, CO
National Provider Identifier
1194480541
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
C-APN.0106561 Issued in CO
Practice address
6380 Promenade Pkwy
Castle Rock, CO 80108-1909
Phone
(720) 734-1126
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X C-APN.0106561 CO Primary
Nurse Practitioner 363L00000X GAA-NP000506 GA

Addresses

Primary practice location

6380 Promenade Pkwy
Castle Rock, CO 80108-1909

Mailing address

6380 Promenade Pkwy
Castle Rock, CO 80108-1909
Phone (720) 734-1126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20211208003114 GA Practitioner - Nurse Practitioner 0042600959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234893SCMDRegistered Nurse
GAA-NP000506GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Nov 19, 2021 Accepting new patients
Au Medical Associates Inc CurrentSince Nov 19, 2021 Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1194480541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6380 PROMENADE PKWY",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801081909",
            "telephone_number": "720-734-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6380 PROMENADE PKWY",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801081909",
            "telephone_number": "720-734-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZEMORE",
        "first_name": "MIRANDA",
        "middle_name": "ALEXANDER",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0106561",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP000506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

Verify at the official NPI Registry.