Active NPI
Miranda Nicole Morgan, MD
- Emergency Medicine Physician
- Chicago, IL
National Provider Identifier
1366109837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 125.081450
- Practice address
- 1740 W Taylor St
Chicago, IL 60612-7232 - Phone
- (312) 996-7297
- NPI assigned
- Nov 19, 2021
- Last updated
- Jun 15, 2023
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 125.081450 | IL | Primary |
Addresses
Primary practice location
1740 W Taylor St
Chicago, IL 60612-7232
Mailing address
1360 N Lake Shore Dr Apt 1910
Chicago, IL 60610-8468
Phone (949) 742-4415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230601000424 | IL | Order and Referring Only - Emergency Medicine | 5991162208 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.081450 | IL | MD | Emergency Medicine Physician |
Interoperability endpoints
- mmorgan138923@uihealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1366109837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 N LAKE SHORE DR APT 1910",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606108468",
"telephone_number": "949-742-4415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1740 W TAYLOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606127232",
"telephone_number": "312-996-7297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORGAN",
"first_name": "MIRANDA",
"middle_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-19",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "IL",
"license": "125.081450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.