Active NPI
Kinga Miranda, OTR/L
- Occupational Therapist
- Bullhead City, AZ
National Provider Identifier
1508161340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3538
- Practice address
- 2812 Silver Creek Rd
Bullhead City, AZ 86442-8309 - Phone
- (928) 763-1404
- NPI assigned
- Jan 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 3538 | AZ | Primary |
| Occupational Therapist | 225X00000X | 10-0070 | NV |
Addresses
Primary practice location
2812 Silver Creek Rd
Bullhead City, AZ 86442-8309
Mailing address
2152 Tumbleweed Dr
Mohave Valley, AZ 86440-8945
Phone (928) 770-5026
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3538 | AZ | MD | Clinical Psychologist |
| 10-0070 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295913600000",
"number": "1508161340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2152 TUMBLEWEED DR",
"city": "MOHAVE VALLEY",
"state": "AZ",
"postal_code": "864408945",
"telephone_number": "928-770-5026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2812 SILVER CREEK RD",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "864428309",
"telephone_number": "928-763-1404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "KINGA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-25",
"last_updated": "2011-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "3538",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "10-0070",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bullhead City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.