Individual provider Active NPI

Miranda Lynne Cheney, CRNP

  • Registered Nurse
  • Tuscaloosa, AL
National Provider Identifier
1467840280
Registry record updated Jan 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1-126137 Issued in AL
Practice address
3611 Windy RDG
Tuscaloosa, AL 35406-3676
Phone
(205) 344-9028
Fax
(205) 344-9031
NPI assigned
Dec 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2015

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 1-126137 AL Primary

Addresses

Primary practice location

3611 Windy RDG
Tuscaloosa, AL 35406-3676

Mailing address

315 Main Ave
Northport, AL 35476-5057
Phone (205) 344-9028

Other identifiers 2

IdentifierTypeStateIssuer
1-126137OtherALALABAMA BOARD OF NURSING
2013018826OtherALAMERICAN NURSES CREDENTIALING CENTER

Other names 1

  • Miranda Lynne Winter Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150513000612 AL Practitioner - Nurse Practitioner 4183944291 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Physician Group, LLP CurrentSince Dec 8, 2014 Accepting new patients

Locations

315 Main Ave
Northport, AL 35476
Phone (205) 344-9019

1655 McFarland Blvd N
Tuscaloosa, AL 35406
Phone (205) 301-8930

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1419984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420156800000",
    "number": "1467840280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MAIN AVE",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354765057",
            "telephone_number": "205-344-9028",
            "fax_number": "205-344-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 WINDY RDG",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354063676",
            "telephone_number": "205-344-9028",
            "fax_number": "205-344-9031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENEY",
        "first_name": "MIRANDA",
        "middle_name": "LYNNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-31",
        "last_updated": "2015-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-126137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA BOARD OF NURSING",
            "identifier": "1-126137",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2013018826",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "WINTER",
            "middle_name": "LYNNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.