Individual provider Active NPI

Miranda Marie Floyd, AGACNP

  • Gerontology Nurse Practitioner
  • Maryville, MO
National Provider Identifier
1215452289
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
20170357250 Issued in MO
Practice address
2016 S Main St
Maryville, MO 64468-2655
Phone
(660) 562-7999
Fax
(660) 562-7996
NPI assigned
Aug 10, 2017
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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 20170357250 MO Primary

Addresses

Primary practice location

2016 S Main St
Maryville, MO 64468-2655

Mailing address

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-7999

Other practice location 1

5908 State Highway P
Albany, MO 64402-8241
Phone (660) 254-2269

Other identifiers 1

IdentifierTypeStateIssuer
420047320MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20171128001624 MO Practitioner - Nurse Practitioner 2163700790 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Regional Health ServicesGroup PAC ID 8921917352, shared by 13 NPIs, 165 clinicians

Practice addresses (Care Compare)

114 E S Hills Dr
Maryville, MO 64468-2659

2016 S Main St
Maryville, MO 64468-2655
Phone (660) 562-2525

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.52 of 100Reported as group
Quality
73.6
Promoting interoperability
100
Improvement activities
40
Cost
81.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20170357250MOMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Regional Medical Center CurrentSince Oct 23, 2017 Accepting new patients
Heartland Regional Medical Center CurrentSince Oct 23, 2017 Accepting new patients
Heartland Regional Medical Center Past Accepting new patients
Mosaic Medical Center - Maryville Past Accepting new patients

Locations

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

802 N Riverside Rd
Ste G50
Saint Joseph, MO 64507
Phone (816) 271-6666

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1395

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1215452289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-7999",
            "fax_number": "660-562-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S MAIN ST",
            "city": "MARYVILLE",
            "state": "MO",
            "postal_code": "644682655",
            "telephone_number": "660-562-7999",
            "fax_number": "660-562-7996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5908 State Highway P",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "MO",
            "postal_code": "644028241",
            "country_code": "US",
            "telephone_number": "660-254-2269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FLOYD",
        "first_name": "MIRANDA",
        "middle_name": "MARIE",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "20170357250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420047320",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, MO

Sources for this page

Verify at the official NPI Registry.