Active NPI
Miriam M Jackson, PNP
- Pediatric Nurse Practitioner
- Austin, TX
National Provider Identifier
1588905541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP123315
- Practice address
- 7940 Shoal Creek Blvd Ste 100
Austin, TX 78757-7589 - Phone
- (512) 494-4000
- Fax
- (512) 494-4024
- NPI assigned
- Mar 14, 2013
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP123315 | TX | Primary |
Addresses
Primary practice location
7940 Shoal Creek Blvd Ste 100
Austin, TX 78757-7589
Mailing address
7940 Shoal Creek Blvd Ste 100
Austin, TX 78757-7589
Phone (512) 494-4000
Other practice location 1
5301 Davis Ln Ste 200A
Austin, TX 78749-4062
Phone (512) 494-4000
Other names 1
- Miriam E Murillo
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP123315 | TX | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- miriam.jackson.1@13029.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1588905541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7940 SHOAL CREEK BLVD STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787577589",
"telephone_number": "512-494-4000",
"fax_number": "512-494-4024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7940 SHOAL CREEK BLVD STE 100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787577589",
"telephone_number": "512-494-4000",
"fax_number": "512-494-4024"
}
],
"practiceLocations": [
{
"address_1": "5301 Davis Ln Ste 200A",
"address_purpose": "LOCATION",
"city": "Austin",
"state": "TX",
"postal_code": "787494062",
"country_code": "US",
"telephone_number": "512-494-4000",
"fax_number": "512-494-4090",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JACKSON",
"first_name": "MIRIAM",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "PNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-14",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "TX",
"license": "AP123315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MIRIAM",
"last_name": "MURILLO",
"middle_name": "E",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.