Individual provider Active NPI

Miranda Michelle Beckler, FNP-BC

  • Family Nurse Practitioner
  • Morristown, TN
National Provider Identifier
1235605296
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
024745 Issued in TN
Practice address
4138 Durham LNDG
Morristown, TN 37813-1006
Phone
(423) 586-1717
Fax
(423) 586-1763
NPI assigned
Oct 17, 2018
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 024745 TN Primary

Addresses

Primary practice location

4138 Durham LNDG
Morristown, TN 37813-1006

Mailing address

4138 Durham LNDG
Morristown, TN 37813-1006
Phone (423) 586-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190123000099 TN Practitioner - Nurse Practitioner 7911244454 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthstar Physicians PCGroup PAC ID 5890690978, 89 clinicians

Practice addresses (Care Compare)

121 Newport Towne Ctr
Newport, TN 37821-7391
Phone (423) 532-8621

3614 W Andrew Johnson Hwy
Morristown, TN 37814-3602
Phone (423) 586-9495

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024745TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 9, 2022 Accepting new patients
Healthstar Physicians, P.C. CurrentSince Dec 5, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Aug 9, 2022 Accepting new patients
Healthstar Physicians PC CurrentSince Dec 5, 2018 Accepting new patients
East Tennessee Primary Care Associates Past Accepting new patients

Locations

1112 N Main Ave
Erwin, TN 37650
Phone (423) 560-6010

657 E Broadway Blvd
Ste C
Jefferson Cty, TN 37760
Phone (423) 586-1717

4138 Durham Lndg
Morristown, TN 37813
Phone (423) 586-1717

420 W Morris Blvd
Ste 400A
Morristown, TN 37813
Phone (423) 318-6617

420 W Morris Blvd
Ste 400C
Morristown, TN 37813
Phone (423) 586-0443

121 Newport Towne Ctr
Newport, TN 37821
Phone (423) 532-8621

994 W Highway 25 70
Ste 4
Newport, TN 37821
Phone (423) 237-6964

Interoperability endpoints

  • Direct secure messaging: miranda.beckler.1@3525.direct.athenahealth.com

Organizations & group practices 6

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": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1235605296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4138 DURHAM LNDG",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131006",
            "telephone_number": "423-586-1717",
            "fax_number": "423-586-1763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4138 DURHAM LNDG",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378131006",
            "telephone_number": "423-586-1717",
            "fax_number": "423-586-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKLER",
        "first_name": "MIRANDA",
        "middle_name": "MICHELLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "024745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.