Miranda Ivers, MOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT4562 Issued in NM

Practice address

930 12TH St S
Brookings, SD 57006-3877

Phone

(605) 695-6881

NPI assigned

Oct 4, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1346912763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 12TH ST S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063877",
            "telephone_number": "605-695-6881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 12TH ST S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063877",
            "telephone_number": "605-695-6881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERS",
        "first_name": "MIRANDA",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "OT4562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Brookings, SD
• Providers in Brookings, SD by specialty
• Occupational Therapist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.