Individual provider Active NPI

Taylor Ann Miracle, DC

  • Chiropractor
  • Lake Havasu City, AZ
National Provider Identifier
1336947019
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
9427 Issued in AZ
Practice address
30 Acoma Blvd S
Lake Havasu City, AZ 86403-5957
Phone
(928) 680-9500
NPI assigned
Mar 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 9427 AZ Primary

Addresses

Primary practice location

30 Acoma Blvd S
Lake Havasu City, AZ 86403-5957

Mailing address

2875 Bluewater Dr
Lake Havasu City, AZ 86403-5311
Phone (661) 547-0642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528002524 AZ Practitioner - Chiropractic 9638698145 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manipulators IncGroup PAC ID 7618962440, 2 clinicians

Practice addresses (Care Compare)

30 Acoma Blvd S
Suite 203
Lake Havasu City, AZ 86403-5920
Phone (928) 680-9500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Manipulators Inc Chiropractor CurrentSince May 1, 2025 Accepting new patients
Louis a. King D.C.P.C. Chiropractor PastSince May 1, 2025 Accepting new patients

Locations

30 Acoma Blvd S
Ste 203
Lk Havasu Cty, AZ 86403
Phone (928) 680-9500

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1741219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1336947019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 BLUEWATER DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035311",
            "telephone_number": "661-547-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ACOMA BLVD S",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035957",
            "telephone_number": "928-680-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "TAYLOR",
        "middle_name": "ANN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-06",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "9427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.