Miravista Diagnostics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MIRAVISTA DIAGNOSTICS, LLC

Practice address

4444 Decatur Blvd
Suite 300
Indianapolis, IN 46241-9537

Phone

(317) 856-2681

Fax

(317) 856-3685

NPI assigned

Jun 21, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lawrence J Wheat, M.D.

Title

President and Director

Phone

(317) 856-2681

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Arryn Craney, PHD (D)ABMM

  • Clinical Pathology/Laboratory Medicine Physician
  • Indianapolis, IN
  • NPI 1891353710
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1588600456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 DECATUR BLVD",
            "address_2": "SUITE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462419537",
            "telephone_number": "317-856-2681",
            "fax_number": "317-856-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 DECATUR BLVD",
            "address_2": "SUITE 300",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462419537",
            "telephone_number": "317-856-2681",
            "fax_number": "317-856-3685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRAVISTA DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHEAT",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT AND DIRECTOR",
        "authorized_official_telephone_number": "317-856-2681",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP (COLLEGE OF AM PATH)",
            "identifier": "7182293",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savanna Marie Miracle
• Charles Miramonti, M.D.
• Milagros Erica Miranda Delgado, DDS
• Vincent Miranda, MD
• Miratouch LLC
• Mary Mireles, LMHC, NCC
• Lauren Ashley Mirkov
• Ginat Wintermeyer Mirowski, DMD MD
• Gary W Misamore, MD
• Addison Jo Misch

• Clinical Medical Laboratory in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.