Miracl, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MIRACL, LLC

Practice address

1050 W 10TH St # US
Rolla, MO 65401-2905

Phone

(314) 454-8181

Fax

(314) 747-1429

NPI assigned

Jan 31, 2023

Last updated

Jan 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cathy Eghigian

Title

Sr. Director, Managed Care

Phone

(618) 791-0975

Specialties & licenses 1

Addresses

Other names 1

• MIRACL - OB Ultrasound Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard L Wahl, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
  • NPI 1598701203
  NPD

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1518663731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST # US",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "314-454-8181",
            "fax_number": "314-747-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W 10TH ST # US",
            "city": "ROLLA",
            "state": "MO",
            "postal_code": "654012905",
            "telephone_number": "314-454-8181",
            "fax_number": "314-747-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "EGHIGIAN",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "SR. DIRECTOR,  MANAGED CARE",
        "authorized_official_telephone_number": "618-791-0975"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIRACL - OB Ultrasound",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Vera Mikhailova, MD
• Joshua Ryan Miller, DO
• Margaret P. Miller, L.C.S.W.
• Jonathan Lee Minor, M.D.
• Miracl, LLC
• Haley Misner
• Missouri CVS Pharmacy LLC (CVS Pharmacy #10280)
• Missouri Home Care (An Auxi Health Company)
• Missouri Home Care (Auxi Health Company)
• Missouri Home Care of Rolla (Auxi Health Company)

• Medical Specialty Clinic/Center in Rolla, MO
• Providers in Rolla, MO by specialty
• Medical Specialty Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.