Individual provider Active NPI

Miranda Allyssa Giddens, PA

  • Physician Assistant
  • Columbus, IN
National Provider Identifier
1326926965
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004954A Issued in IN
Practice address
2400 17TH St
Columbus, IN 47201-5351
Phone
(812) 376-5974
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004954A IN Primary

Addresses

Primary practice location

2400 17TH St
Columbus, IN 47201-5351

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgiddens54969@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250904003653 IN Practitioner - Physician Assistant 0345742862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbus Regional Health Physicians LLCGroup PAC ID 1052612314, 216 clinicians

Practice addresses (Care Compare)

2400 17TH St
Columbus, IN 47201-5351
Phone (812) 376-5974

Hospital & facility affiliations

  • Columbus Regional Hospital Hospital, Columbus, IN, CCN 150112
  • Ascension St Vincent Jennings Hospital, North Vernon, IN, CCN 151303

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10004954AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC CurrentSince Aug 27, 2025 Accepting new patients
Columbus Regional Health Physicians, LLC CurrentSince Aug 27, 2025 Accepting new patients
Columbus Regional Health Physicians, LLC Past Accepting new patients

Locations

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1326926965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 17TH ST",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472015351",
            "telephone_number": "812-376-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIDDENS",
        "first_name": "MIRANDA",
        "middle_name": "ALLYSSA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004954A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgiddens54969@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct address",
            "address_1": "2400 17th St",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.