Vicki Lynn Miracle, R.N.

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

090000670RN Issued in OR

Practice address

19824 S Butte Rd
Beavercreek, OR 97004-8847

Phone

(503) 632-7077

Fax

(503) 336-1850

NPI assigned

May 30, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1376701888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19824 S BUTTE RD",
            "city": "BEAVERCREEK",
            "state": "OR",
            "postal_code": "970048847",
            "telephone_number": "503-632-7077",
            "fax_number": "503-336-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19824 S BUTTE RD",
            "city": "BEAVERCREEK",
            "state": "OR",
            "postal_code": "970048847",
            "telephone_number": "503-632-7077",
            "fax_number": "503-336-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "VICKI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "OR",
            "license": "090000670RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Bartko, CNM
• Discovery Practice Management, Inc.
• Elite Performance Physical Therapy, LLC
• Deborah Frances, N.D.
• Greg Glenn Gill Jr.
• Joelle Osterhaus, LCSW
• Jessie Lynn Roberts, DPT
• Laura Ann Shattuck, PNP
• Graham Douglas Shea, D.D.S.
• The Good Practice LLC

• Community Health Registered Nurse in Beavercreek, OR
• Providers in Beavercreek, OR by specialty
• Community Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.