Individual provider Active NPI

Miranda Nicole Corona, MD

  • Obstetrics & Gynecology Physician
  • Richmond Heights, MO
National Provider Identifier
1275235772
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2023019896 Issued in MO
Practice address
6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone
(314) 781-4772
NPI assigned
Mar 20, 2023
Last updated
Sep 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2023019896 MO Primary

Addresses

Primary practice location

6420 Clayton Rd
Richmond Heights, MO 63117-1811

Mailing address

1229 Allen Market LN
Saint Louis, MO 63104-3941
Phone (636) 970-9029

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230629000435 MO Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 3779942438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2023019896MOMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1275235772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 ALLEN MARKET LN",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631043941",
            "telephone_number": "636-970-9029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-781-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONA",
        "first_name": "MIRANDA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2023019896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Heights, MO

Sources for this page

Verify at the official NPI Registry.