Individual provider Active NPI

Miranda Faith King McGhee, APN

  • Family Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1407194269
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17323 Issued in TN
Practice address
1169 Jefferson Ave
Memphis, TN 38104-7217
Phone
(901) 452-1880
Fax
(901) 725-5768
NPI assigned
Jan 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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 17323 TN Primary

Addresses

Primary practice location

1169 Jefferson Ave
Memphis, TN 38104-7217

Mailing address

1169 Jefferson Ave
Memphis, TN 38104-7217
Phone (901) 452-1880

Other identifiers 1

IdentifierTypeStateIssuer
Q000475MedicaidTN

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
I20130522000666 TN Practitioner - Nurse Practitioner 4981842408 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17323TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Tennessee LLC Family CurrentSince Feb 27, 2018 Accepting new patients
Wci School Health Services, PLLC Family CurrentSince Aug 12, 2013 Accepting new patients
Carelon Medical Partners of Arizona, P.C. CurrentSince Jun 30, 2022 Accepting new patients
Kroger Limited Partnership I PastSince Feb 27, 2018 Accepting new patients
Carelon Medical Partners of Arizona, P.C. Past Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

7615 US Highway 70
Bartlett, TN 38133
Phone (901) 758-3625

1212 Vollintine Ave
Memphis, TN 38107
Phone (901) 531-6321

6518 Quince Rd
Memphis, TN 38119
Phone (901) 229-2283

2449 Old Fort Pkwy
Murfreesboro, TN 37128
Phone (615) 225-0140

Interoperability endpoints

  • Direct secure messaging: miranda.mcghee.p1@direct.caremoreagp.nextgenshare.com
  • Direct secure messaging: miranda.mcghee.1@32527.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1407194269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047217",
            "telephone_number": "901-452-1880",
            "fax_number": "901-725-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 JEFFERSON AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381047217",
            "telephone_number": "901-452-1880",
            "fax_number": "901-725-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGHEE",
        "first_name": "MIRANDA",
        "middle_name": "FAITH KING",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000475",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.