Miracle Makers Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MHL-070-057 Issued in NC

Legal business name

MIRACLE MAKERS INC

Practice address

305 East Main Street
Elizabeth City, NC 27909-1200

Phone

(252) 331-2174

NPI assigned

Mar 8, 2011

Organization subpart

No

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

Authorized official

Name

Miss Zoya Gornopolsky

Title

Owner

Phone

(252) 331-2174

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311552000000",
    "number": "1255639720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 EAST MAIN STREET",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279091200",
            "telephone_number": "252-331-2174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 EAST MAIN STREET",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279091200",
            "telephone_number": "252-331-2174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE MAKERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2011-07-25",
        "status": "A",
        "authorized_official_last_name": "GORNOPOLSKY",
        "authorized_official_first_name": "ZOYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-331-2174",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NC",
            "license": "MHL-070-057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Wesley Miller, D.O.
• Jenna Meads Miller, COTA/L, CLT, PCC
• Karen Anne Miller, DENTAL HYGIENIST
• Elizabeth Milliner, BCBA
• Gerald Mimlitsch
• Ananya Mishra, MD
• Betsy Sue Kirkpatrick Mitcham, NP
• Demetria Mitchell
• Valerie Mitchell, M.S. CCC-SLP
• Peter V Mitrev, M.D.

• Community/Behavioral Health Agency in Elizabeth City, NC
• Providers in Elizabeth City, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.