Kristin Alvis Miranda

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5735 Issued in TN

Practice address

1869 Crest Rd
Maryville, TN 37804-4304

Phone

(865) 210-7825

NPI assigned

Sep 2, 2022

Last updated

Sep 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Functional Pathways Preferred of Tennessee LLCGroup PAC ID 2860649654, 194 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  DC, VA

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1215657788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 PEBBLE CREEK RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379189754",
            "telephone_number": "540-908-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1869 CREST RD",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378044304",
            "telephone_number": "865-210-7825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Hugh Wallis Rd S",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705082511",
            "country_code": "US",
            "telephone_number": "865-210-7825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "KRISTIN",
        "middle_name": "ALVIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "5735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig Miller Jr., MD
• Paul Warrick Miller, M.D.
• Tanya Lynette Miller
• Emilee Blosser Milne, PT, DPT
• Rachel Minzyk, MS
• Alison Mistak, LCSW
• Lainy Mistich, LPC-MHSP
• Mary Carol Misulich, LCSW
• Hannah K Mitchell
• Karen Crain Mitchell, NP

• Speech-Language Pathologist in Maryville, TN
• Providers in Maryville, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.