Individual provider Active NPI

Miranda Pacheco, RN

  • Registered Nurse
  • Middletown, RI
National Provider Identifier
1417537481
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN64510 Issued in RI
Practice address
65 Valley Rd
Middletown, RI 02842-5234
Phone
(018) 466-6204
Fax
(401) 848-6394
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN64510 RI Primary

Addresses

Primary practice location

65 Valley Rd
Middletown, RI 02842-5234

Mailing address

127 Johnny Cake Hill Rd
Middletown, RI 02842-5674
Phone (401) 846-1213

Other practice location 1

127 Johnny Cake Hill Rd
Middletown, RI 02842-5674
Phone (401) 846-1213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN64510RIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1417537481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 JOHNNY CAKE HILL RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425674",
            "telephone_number": "401-846-1213",
            "fax_number": "401-848-6398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 VALLEY RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028425234",
            "telephone_number": "018-466-6204",
            "fax_number": "401-848-6394"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Johnny Cake Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "RI",
            "postal_code": "028425674",
            "country_code": "US",
            "telephone_number": "401-846-1213",
            "fax_number": "401-848-6398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "MIRANDA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN64510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.