Individual provider Active NPI

Miranda Lee

  • Family Nurse Practitioner
  • West Monroe, LA
National Provider Identifier
1568089324
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
214150 Issued in LA
Practice address
2933 Cypress St Ste 1
West Monroe, LA 71291-5468
Phone
(318) 322-9252
Fax
(318) 397-1873
NPI assigned
Jun 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 214150 LA Primary

Addresses

Primary practice location

2933 Cypress St Ste 1
West Monroe, LA 71291-5468

Mailing address

PO Box 2673
West Monroe, LA 71294-2673
Phone (318) 322-9252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20231129003964 LA Practitioner - Nurse Practitioner 1951759026 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lamy Lane Family Medicine LLCGroup PAC ID 4486169117, 2 clinicians

Practice addresses (Care Compare)

1805 Lamy LN
Monroe, LA 71201-3739
Phone (318) 388-5383

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
214150LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Provision Health Care LLC Family CurrentSince Oct 17, 2023 Accepting new patients
Lamy Lane Family Medicine LLC CurrentSince Jul 1, 2025 Accepting new patients
One Source Medical Management, Inc. Current Accepting new patients
Provision Health Care LLC Family CurrentSince Oct 17, 2023 Accepting new patients

Locations

1805 Lamy Ln
Monroe, LA 71201
Phone (318) 388-5383

2933 Cypress St
Ste 1
West Monroe, LA 71291
Phone (318) 322-3637

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19369/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1593302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1568089324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2673",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712942673",
            "telephone_number": "318-322-9252",
            "fax_number": "318-397-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2933 CYPRESS ST STE 1",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915468",
            "telephone_number": "318-322-9252",
            "fax_number": "318-397-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-28",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "214150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Monroe, LA

Sources for this page

Verify at the official NPI Registry.