Miranda Korrin Peck, LPN

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

101 Fox St
Sidney, NY 13838-1530

Phone

(607) 434-4209

NPI assigned

Jul 15, 2019

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2019.

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1316599889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 FOX ST",
            "city": "SIDNEY",
            "state": "NY",
            "postal_code": "138381530",
            "telephone_number": "607-434-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FOX ST",
            "city": "SIDNEY",
            "state": "NY",
            "postal_code": "138381530",
            "telephone_number": "607-434-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "MIRANDA",
        "middle_name": "KORRIN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "329267",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Nichols, LCSW
• OBGYN of Sidney PC
• Kelly Ann Palmatier, RPH
• Julia Marie Parsons, DNP, FNP
• Khalid Parwez, MD
• Meaghan Leigh Provost, NP
• Renee Beth Rideout, PTA
• Jennifer Jill Rivers, RN
• Amber Robertson, LMSW
• Rocky Mountain Holdings, LLC

• All providers in Sidney, NY
• Home Health Aide in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.