Individual provider Active NPI

Miranda Moritz, ANP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1366862336
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18600 Issued in TN
Practice address
2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396
Phone
(423) 282-5054
Fax
(423) 390-6850
NPI assigned
Apr 17, 2014
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18600 TN Primary

Addresses

Primary practice location

2428 Knob Creek Rd Ste 201
Johnson City, TN 37604-2396

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

310 N State Of Franklin Rd Ste 400
Johnson City, TN 37604-6051
Phone (423) 979-6000

Other practice location 2

1901 S Shady St Ste 1
Mountain City, TN 37683-2021
Phone (423) 727-6674

Other practice location 3

1497 W Elk Ave Ste 22A
Elizabethton, TN 37643-2896
Phone (423) 547-3380

Other practice location 4

1410 Tusculum Blvd Ste 1200
Greeneville, TN 37745-5815
Phone (423) 638-2270

Other practice location 5

1410 Tusculum Blvd Ste 1500
Greeneville, TN 37745-5810
Phone (423) 638-2270

Other practice location 6

2050 Meadowview Pkwy
Kingsport, TN 37660-7332
Phone (423) 230-5000

Other identifiers 2

IdentifierTypeStateIssuer
1366862336MedicaidVA
Q005480MedicaidTN

Other names 1

  • Miranda Kyker Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20140624001861 TN Practitioner - Nurse Practitioner 8123242690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

310 N State of Franklin Rd
Suite 400
Johnson City, TN 37604-6051
Phone (423) 979-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Cardiology Services Family CurrentSince May 22, 2022 Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

2428 Knob Creek Rd
Ste 201
Johnson City, TN 37604
Phone (423) 262-4400

310 N State of Franklin Rd
Ste 400
Johnson City, TN 37604
Phone (423) 929-7393

2050 Meadowview Pkwy
Kingsport, TN 37660

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1366862336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 KNOB CREEK RD STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042396",
            "telephone_number": "423-282-5054",
            "fax_number": "423-390-6850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 N State Of Franklin Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046051",
            "country_code": "US",
            "telephone_number": "423-979-6000",
            "fax_number": "423-979-6011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1901 S Shady St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Mountain City",
            "state": "TN",
            "postal_code": "376832021",
            "country_code": "US",
            "telephone_number": "423-727-6674",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1497 W Elk Ave Ste 22A",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432896",
            "country_code": "US",
            "telephone_number": "423-547-3380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 Tusculum Blvd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377455815",
            "country_code": "US",
            "telephone_number": "423-638-2270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1410 Tusculum Blvd Ste 1500",
            "address_purpose": "LOCATION",
            "city": "Greeneville",
            "state": "TN",
            "postal_code": "377455810",
            "country_code": "US",
            "telephone_number": "423-638-2270",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 Meadowview Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376607332",
            "country_code": "US",
            "telephone_number": "423-230-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORITZ",
        "first_name": "MIRANDA",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366862336",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q005480",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "KYKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.