Active NPI
Mikayla Miranda, OTR/L
- Occupational Therapist
- Louisville, KY
National Provider Identifier
1588286777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13528
- Practice address
- 2701 Chestnut Station CT
Louisville, KY 40299-6395 - Phone
- (800) 335-1060
- NPI assigned
- May 11, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13528 | MA | Primary |
Addresses
Primary practice location
2701 Chestnut Station CT
Louisville, KY 40299-6395
Mailing address
70 Hall St
Feeding Hills, MA 01030-1926
Phone (413) 519-8772
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5419 | Other | CT | DEPARTMENT OF PUBLIC HEALTH |
| 13528 | Other | MA | MASSACHUSETTS BOARD OF ALLIED HEALTH PROFESSIONALS |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589155200000",
"number": "1588286777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 HALL ST",
"city": "FEEDING HILLS",
"state": "MA",
"postal_code": "010301926",
"telephone_number": "413-519-8772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 CHESTNUT STATION CT",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402996395",
"telephone_number": "800-335-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "MIKAYLA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-11",
"last_updated": "2020-05-11",
"certification_date": "2020-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "13528",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPARTMENT OF PUBLIC HEALTH",
"identifier": "5419",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSACHUSETTS BOARD OF ALLIED HEALTH PROFESSIONALS",
"identifier": "13528",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.