Active NPI
Miranda Wikert
- Registered Nurse
- Castle Rock, CO
National Provider Identifier
1346794468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1631127
- Practice address
- 2036 Saddleback Dr
Castle Rock, CO 80104-9493 - Phone
- (909) 936-4861
- NPI assigned
- Aug 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1631127 | CA | Primary |
Addresses
Primary practice location
2036 Saddleback Dr
Castle Rock, CO 80104-9493
Mailing address
2036 Saddleback Dr
Castle Rock, CO 80104-9493
Other names 1
- Miranda Fugate
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1631127 | CA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470355200000",
"number": "1346794468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2036 SADDLEBACK DR",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801049493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2036 SADDLEBACK DR",
"city": "CASTLE ROCK",
"state": "CO",
"postal_code": "801049493",
"telephone_number": "909-936-4861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIKERT",
"first_name": "MIRANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-05",
"last_updated": "2016-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "1631127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MIRANDA",
"last_name": "FUGATE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Castle Rock, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.