Miranda Elyse Perotti, RN IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

878063 Issued in TX

Practice address

2101 West Ave Unit 101
San Antonio, TX 78201-2822

Phone

(281) 305-0411

Fax

(281) 572-0627

NPI assigned

Aug 25, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miranda Elyse Palmer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Bayou City Breastfeeding, LLC

  • Lactation Consultant (Registered Nurse)
  • Houston, TX
  • NPI 1376056085
  NPD
• Cardiothoracic Surgery, LLC

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Chesterfield, MO
  • NPI 1104895812
  NPD (past)

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1376328732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 WOODLAND HILLS DR # 205",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "773391403",
            "telephone_number": "281-305-0411",
            "fax_number": "281-572-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WEST AVE UNIT 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782012822",
            "telephone_number": "281-305-0411",
            "fax_number": "281-572-0627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 Old San Antonio Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Boerne",
            "state": "TX",
            "postal_code": "780063339",
            "country_code": "US",
            "telephone_number": "281-305-0411 x2",
            "fax_number": "281-572-0627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEROTTI",
        "first_name": "MIRANDA",
        "middle_name": "ELYSE",
        "credential": "RN IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "878063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "PALMER",
            "middle_name": "ELYSE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Senta Pernell, DENTAL HYGIENST
• Pernicano Professional Psychology, PLLC
• Pernicano Psychological Services, PLLC
• Kevin Michael Pernicano, PHD
• Abby Marie Perone, D.C.
• Peter Timothy Perretta, M.D.
• Catherine Renee Perri, LCSW
• Alice Perrier
• Briana Perrier
• Perrin Beitel Dental, PC

• Lactation Consultant (Registered Nurse) in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Lactation Consultant (Registered Nurse) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.