Individual provider Active NPI

Miranda Bunge, DC

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1245618420
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5471 Issued in KY
Practice address
3407 Fern Valley Rd
Louisville, KY 40213-3529
Phone
(502) 961-9355
Fax
(502) 961-9357
NPI assigned
May 8, 2015
Last updated
Feb 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1234 TN
Chiropractor 111N00000X 5471 KY Primary

Addresses

Primary practice location

3407 Fern Valley Rd
Louisville, KY 40213-3529

Mailing address

8678 Ramsey LN
Du Quoin, IL 62832-3862
Phone (618) 318-1351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160307002792 KY Practitioner - Chiropractic 6103137542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jones Chiropractic and Massage IncGroup PAC ID 5597910109, 4 clinicians

Practice addresses (Care Compare)

3407 Fern Valley Rd
Louisville, KY 40213-3529
Phone (502) 961-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1234TNMDMarriage & Family Therapist
2873TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jones Chiropractic and Massage Inc Chiropractor CurrentSince Mar 1, 2016 Accepting new patients

Locations

3407 Fern Valley Rd
Louisville, KY 40213
Phone (502) 961-9355

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1245618420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8678 RAMSEY LN",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "628323862",
            "telephone_number": "618-318-1351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 FERN VALLEY RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402133529",
            "telephone_number": "502-961-9355",
            "fax_number": "502-961-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNGE",
        "first_name": "MIRANDA",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-08",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "1234",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "5471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.