Active NPI
Winellen Miranda
- Health & Wellness Coach
- Smyrna, GA
National Provider Identifier
1548071269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health & Wellness Coach
- License
- 26NR17818000
- Practice address
- 3328 Hidden Trail Rd SE
Smyrna, GA 30082-2441 - Phone
- (631) 546-8595
- NPI assigned
- Jan 14, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health & Wellness Coach | 171400000X | 26NR17818000 | NJ | Primary |
Addresses
Primary practice location
3328 Hidden Trail Rd SE
Smyrna, GA 30082-2441
Mailing address
3328 Hidden Trail Rd SE
Smyrna, GA 30082-2441
Phone (631) 546-8595
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NR17818000 | NJ | MD | Health & Wellness Coach |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1548071269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3328 HIDDEN TRAIL RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300822441",
"telephone_number": "631-546-8595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3328 HIDDEN TRAIL RD SE",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300822441",
"telephone_number": "631-546-8595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "WINELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-14",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": "NJ",
"license": "26NR17818000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.