NPIMap

Individual provider Active NPI

Miranda Thomas, NP

  • Family Nurse Practitioner
  • Florence, SC
National Provider Identifier
1417594599
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
23133 Issued in SC
Practice address
1590 Freedom Blvd Ste B
Florence, SC 29505-6071
Phone
(843) 665-9581
NPI assigned
Dec 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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 23133 SC Primary

Addresses

Primary practice location

1590 Freedom Blvd Ste B
Florence, SC 29505-6071

Mailing address

PO Box 602108
Charlotte, NC 28260-2108
Phone (843) 792-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200514000656 SC Practitioner - Nurse Practitioner 9234560871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1590 Freedom Blvd
Suite B
Florence, SC 29505-6071
Phone (843) 792-1414

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23133SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Carolina Family Care, Inc CurrentSince Feb 16, 2020 Accepting new patients
Carolina Family Care, Inc CurrentSince Feb 16, 2020 Accepting new patients
Musc Community Physicians CurrentSince Jan 30, 2022 Accepting new patients
Regional Medical Center of Orangeburg and Calhoun Counties Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

1590 Freedom Blvd
Ste B
Florence, SC 29505
Phone (843) 665-9581

1590 Freedom Blvd
Ste A
Florence, SC 29505
Phone (843) 629-1791

1341 Old Georgetown Rd
Ste C
Mt Pleasant, SC 29464
Phone (843) 884-2175

Interoperability endpoints

  • Direct secure messaging: mthomas253767@direct.musc.edu

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.

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": "1575763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1417594599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602108",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602108",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 FREEDOM BLVD STE B",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056071",
            "telephone_number": "843-665-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MIRANDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-08",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "23133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.