Nathan A Miracle, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

2013001193 Issued in MO

Practice address

3050 E River Bluff Blvd
Ozark, MO 65721

Phone

(417) 820-5610

NPI assigned

Jan 23, 2013

Last updated

Jul 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1326386509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 E RIVER BLUFF BLVD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "657218807",
            "telephone_number": "417-820-5610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 E RIVER BLUFF BLVD",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "telephone_number": "417-820-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "NATHAN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-23",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MO",
            "license": "2013001193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordyn Michelle Meury, M.S. CCC-SLP
• Chester R Michel, LPC
• Melissa Milan, LPC
• Ebere-CHI Miller, NP-C
• Morgan Lyn Miller, M.S. CCC-SLP
• Mobile Fit Physical Therapy LLC
• Mobile X-Ray Services (Kosma Mobile X-Ray)
• Mobile X-Ray Services LLC (Kosma Mobile X-Ray Co)
• Mobile X-Ray Services, LLC (Kosma Mobile X-Ray)
• Tegan Anne Monnig

• Surgical Physician Assistant in Ozark, MO
• Providers in Ozark, MO by specialty
• Surgical Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; 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.