Miranda Deshawna Thomas, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21526 Issued in TN

Practice address

4485 W Stone Dr
Suite 200
Kingsport, TN 37660-1050

Phone

(423) 224-3150

Fax

(423) 224-3169

NPI assigned

Mar 20, 2014

Sex

Female

Sole proprietor

No

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.

• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: miranda.thomas@crhs.eclinicaldirectplus.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 19, 2016.

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471564800000",
    "number": "1629495247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4485 W STONE DR",
            "address_2": "SUITE 200",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376601050",
            "telephone_number": "423-224-3150",
            "fax_number": "423-224-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MIRANDA",
        "middle_name": "DESHAWNA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2016-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024171552",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lenita Thibault, MD
• Julia Thie, L.AC
• Thomas Sturdavant MD PA
• Chadwick J Thomas, M.D.
• Erin Elizabeth Thomas, MSN-FNP
• Sierra Ray Thomas, PA-C
• Thomas Thomas, MD
• Thompson Delivery Services LLC
• Gabriel Ian Guthrie Thompson, PHARMD, MS
• Grant Cole Thompson, PA

• All providers in Kingsport, TN
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.