Individual provider Active NPI

Miranda Johnson, APRN-CNP, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Chester, OH
National Provider Identifier
1548946494
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0034228 Issued in OH
Practice address
5900 W Chester Rd
West Chester, OH 45069-2951
Phone
(844) 533-0315
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0034228 OH Primary

Addresses

Primary practice location

5900 W Chester Rd
West Chester, OH 45069-2951

Mailing address

5900 W Chester Rd
West Chester, OH 45069-2951
Phone (844) 533-0315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240226002271 OH Practitioner - Nurse Practitioner 5395180749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindfully Psychiatry LLCGroup PAC ID 3870961162, 17 clinicians

Practice addresses (Care Compare)

10547 Montgomery Rd
Suite 700
Montgomery, OH 45242-4418
Phone (888) 830-0347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0034228OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindfully Psychiatry LLC CurrentSince Jan 9, 2024 Accepting new patients

Locations

463 Ohio Pike
Ste 102B
Cincinnati, OH 45255
Phone (888) 262-3616

4600 Beechwood Rd
Ste 700
Cincinnati, OH 45244

5050 Blazer Pkwy
Ste 101
Dublin, OH 43017
Phone (614) 451-7346

1251 Nilles Rd
Ste 5
Fairfield, OH 45014
Phone (732) 993-4599

165 W Center St
Ste 400
Marion, OH 43302
Phone (740) 382-3874

10547 Montgomery Rd
Ste 700
Montgomery, OH 45242
Phone (513) 393-0300

11565 Pearl Rd
Ste 200
Strongsville, OH 44136
Phone (440) 846-0862

5900 W Chester Rd
Ste C
West Chester, OH 45069
Phone (513) 777-2428

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1548946494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 W CHESTER RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692951",
            "telephone_number": "844-533-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 W CHESTER RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450692951",
            "telephone_number": "844-533-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MIRANDA",
        "credential": "APRN-CNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "0034228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.