NPIMap

Individual provider Active NPI

Miranda Fern Hannah, MD

  • Family Medicine Physician
  • Florence, SC
National Provider Identifier
1508507336
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MMD.87779.LL Issued in SC
Practice address
144 N Ravenel St
Florence, SC 29506-2641
Phone
(843) 777-2800
NPI assigned
Apr 5, 2022
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X MMD.87779.LL SC Primary

Addresses

Primary practice location

144 N Ravenel St
Florence, SC 29506-2641

Mailing address

144 N Ravenel St
Florence, SC 29506-2641
Phone (843) 777-2800

Other practice location 1

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-8134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20251009000959 NC Practitioner - Family Practice 3870021959 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

607 E Parker Rd
Morganton, NC 28655-8105
Phone (828) 433-0225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MMD.87779.LLSCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Sep 4, 2025 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. CurrentSince Sep 4, 2025 Accepting new patients
Blue Ridge Healthcare Medical Group, Inc. Family Medicine Past Accepting new patients

Locations

2201 S Sterling St
Morganton, NC 28655
Phone (828) 580-6393

607 E Parker Rd
Morganton, NC 28655
Phone (828) 433-0225

Interoperability endpoints

  • Direct secure messaging: mhannah83630@directmcleodehealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1508507336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 N RAVENEL ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062641",
            "telephone_number": "843-777-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 N RAVENEL ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062641",
            "telephone_number": "843-777-2800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Singleton Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295269142",
            "country_code": "US",
            "telephone_number": "843-347-8134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "MIRANDA",
        "middle_name": "FERN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "MMD.87779.LL",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.