Miranda Henley Theodos

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

525 Alexander St
Jonesboro, LA 71251-2001

Phone

(318) 259-4676

NPI assigned

Aug 3, 2021

Last updated

Aug 16, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Professional Hospice Care, L.L.C.

  dba Allegiance Hospice Care of Northeast Louisiana

  • Community Based Hospice Care Agency
  • Ruston, LA
  • NPI 1649205261
  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1326712449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 TECH FARM RD APT D15",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ALEXANDER ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712512001",
            "telephone_number": "318-259-4676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOS",
        "first_name": "MIRANDA",
        "middle_name": "HENLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Claimtrak",
            "affiliation": "N",
            "endpointDescription": "Website with a very specific URL that needs to be entered and where progress notes and behavioral assessments are stored.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Progress notes and behavioral assessments",
            "address_1": "525 Alexander St",
            "city": "Jonesboro",
            "state": "LA",
            "country_code": "US",
            "postal_code": "712512001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Neshanta Staten
• Stepping Stones Counseling Agency
• Timothy Stewart
• Cynthia Denise Tate
• Dana Telano, LOTR
• Tabitha D Theodos, LMT
• Atsie Nicole Tolar, MS, RD, LDN
• Trustworthy Transit L.L.C.
• Rhonda P Vanburen, RN
• Tiffany Vines

• Case Manager/Care Coordinator in Jonesboro, LA
• Providers in Jonesboro, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.