Individual provider Active NPI

Miranda Poulton

  • Massage Therapist
  • Beachwood, OH
National Provider Identifier
1558299073
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
33.026233 Issued in OH
Practice address
25200 Chagrin Blvd Ste 302
Beachwood, OH 44122-5685
Phone
(216) 302-0947
Fax
(216) 232-6256
NPI assigned
May 13, 2026
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 33.026233 OH Primary

Addresses

Primary practice location

25200 Chagrin Blvd Ste 302
Beachwood, OH 44122-5685

Mailing address

25200 Chagrin Blvd Ste 302
Beachwood, OH 44122-5685
Phone (216) 302-0947

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

LicenseStateTypeSpecialty
33.026233OHMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Watertower Plaza Medical PastSince May 25, 2025 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1778630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1558299073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25200 CHAGRIN BLVD STE 302",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225685",
            "telephone_number": "216-302-0947",
            "fax_number": "216-232-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CHAGRIN BLVD STE 302",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225685",
            "telephone_number": "216-302-0947",
            "fax_number": "216-232-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULTON",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-13",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OH",
            "license": "33.026233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.