Miranda Colletta Horton, M.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

86510 Issued in SC

Practice address

620 Singleton Ridge Rd
Conway, SC 29526-9154

Phone

(843) 347-7300

Fax

(843) 347-8459

NPI assigned

Apr 1, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miranda Denise Colletta Former name

Medicare fee-for-service enrollment

Enrolled in GA, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Otolaryngology

Education

Washington University School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Savannah Multispecialty Associates LLCGroup PAC ID 3678836558, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036

Merit-based Incentive Payment System (MIPS)

Final score

52.78 of 100Reported as group

Quality

55.48

Improvement activities

0

Cost

74.21

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Savannah Multispecialty Associates, LLC

  • Trauma Surgery Physician
  • Savannah, GA
  • NPI 1528571320

  Otolaryngology

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Savannah Health Services, LLC

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  Care Compare affiliation

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1225423601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SINGLETON RIDGE RD",
            "address_2": "ATTN PNS CREDENTIALING",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269142",
            "telephone_number": "843-234-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SINGLETON RIDGE RD",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295269154",
            "telephone_number": "843-347-7300",
            "fax_number": "843-347-8459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6010 Highway 707 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887321",
            "country_code": "US",
            "telephone_number": "843-347-7300",
            "fax_number": "843-347-8459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORTON",
        "first_name": "MIRANDA",
        "middle_name": "COLLETTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "GA",
            "license": "86199",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SC",
            "license": "86510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "865102",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "COLLETTA",
            "middle_name": "DENISE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Horry County Comm on Alcohol & Drug Abuse
• Horry County Disabilities & Special Needs Board
• Horry County Government
• Horry County Rescue Squad Inc
• Horry County Schools
• Elizabeth Patricia Hottell, LISW-CP
• William Houck
• Corey Hough, CHES
• Pearlie Mae Houston
• Randa Mariam Houwari, MD

• Otolaryngology Physician in Conway, SC
• Providers in Conway, SC by specialty
• Otolaryngology Physician in South Carolina

• 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; Order and Referring.
• 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.