Organization Active NPI

William S Mirando MD LLC

  • Specialist
  • Ashtabula, OH
National Provider Identifier
1629269493
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
35-060349M Issued in OH
Legal business name
WILLIAM S MIRANDO MD LLC
Practice address
2885 N Ridge Rd E
Ashtabula, OH 44004-4134
Phone
(440) 998-3376
Fax
(440) 997-5751
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Dr. William Skippon Mirando, MD
Title
Medical Doctor
Phone
(440) 998-3376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 35-060349M OH Primary

Addresses

Primary practice location

2885 N Ridge Rd E
Ashtabula, OH 44004-4134

Mailing address

2885 N Ridge Rd E
Ashtabula, OH 44004-4134
Phone (440) 998-3376

Other identifiers 1

IdentifierTypeStateIssuer
0892780MedicaidOH

National Provider Directory

National Provider Directory

Locations

2885 N Ridge Rd E
Ashtabula, OH 44004
Phone (440) 352-3376

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1629269493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 N RIDGE RD E",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044134",
            "telephone_number": "440-998-3376",
            "fax_number": "440-997-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2885 N RIDGE RD E",
            "city": "ASHTABULA",
            "state": "OH",
            "postal_code": "440044134",
            "telephone_number": "440-998-3376",
            "fax_number": "440-997-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM S MIRANDO MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "MIRANDO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SKIPPON",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "440-998-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-060349M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0892780",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashtabula, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.