Miranda Martin McMahan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.029312 Issued in IL

Practice address

330 SW Adams St
Peoria, IL 61602-1502

Phone

(309) 402-2978

NPI assigned

Feb 16, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  Family

  Medicare reassignment Care Compare group NPD
• Nursing Home Physician Group PLLC

  • Physical Medicine & Rehabilitation Physician
  • Warrenville, IL
  • NPI 1417703844
  NPD (past)

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1528823705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 E CEDAR POINT DR",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615239238",
            "telephone_number": "309-402-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW ADAMS ST",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021502",
            "telephone_number": "309-402-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "MIRANDA",
        "middle_name": "MARTIN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.029312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kathryn McLaughlin, MD
• Roxanne R McLaughlin, APRN, CNP
• Aaron M McLean, PA
• Bruce A McLelland, M.D.
• Elizabeth A McLeod
• Dennis Q McManus, M.D.
• Meagin Abigayle McManus, OTR/L
• Holleigh Madeline McMasters, DO
• Michael E. McMeen, M.S., LCPC
• Mollie McMeen, SLP

• Family Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.