Individual provider Active NPI

Miranda D Withers, ARNP

  • Family Nurse Practitioner
  • Somerset, KY
National Provider Identifier
1427369206
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
6526P Issued in KY
Practice address
349 Bogle St Ste a
Somerset, KY 42503-2895
Phone
(606) 679-0179
Fax
(606) 679-0546
NPI assigned
Jun 28, 2010
Last updated
Dec 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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 6526P KY Primary

Addresses

Primary practice location

349 Bogle St Ste a
Somerset, KY 42503-2895

Mailing address

349 Bogle St Ste a
Somerset, KY 42503-2895
Phone (606) 679-0179

Other identifiers 1

IdentifierTypeStateIssuer
7100130590MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20101011001161 KY Practitioner - Nurse Practitioner 2264624089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
69.66 of 100Reported as group
Quality
39.23
Promoting interoperability
99
Improvement activities
40
Cost
43.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6526PKYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lung and Sleep Disorder Institute PLLC Family CurrentSince Aug 5, 2010 Accepting new patients

Locations

349 Bogle St
Ste A
Somerset, KY 42503
Phone (606) 451-6060

46 Turpen Ct
#B
Somerset, KY 42503
Phone (606) 679-0179

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1427369206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 BOGLE ST STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032895",
            "telephone_number": "606-679-0179",
            "fax_number": "606-679-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 BOGLE ST STE A",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425032895",
            "telephone_number": "606-679-0179",
            "fax_number": "606-679-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERS",
        "first_name": "MIRANDA",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "6526P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100130590",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.