Individual provider Active NPI

Miranda Elizabeth Luce

  • Speech-Language Pathologist
  • Greer, SC
National Provider Identifier
1639635956
Registry record updated Aug 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7731 Issued in SC
Practice address
420 The Pkwy Ste J
Greer, SC 29650-5205
Phone
(864) 244-3474
Fax
(864) 244-3475
NPI assigned
Feb 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Speech-Language Pathologist 235Z00000X 7731 SC Primary

Addresses

Primary practice location

420 The Pkwy Ste J
Greer, SC 29650-5205

Mailing address

5306 Glen Forest Dr
Greenville, SC 29607-6106
Phone (321) 446-1846

Other practice location 1

510 W 10th St
Lynn Haven, FL 32444-2329
Phone (850) 815-8800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7731SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orchard ABA, LLC PastSince Oct 9, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661126400000",
    "number": "1639635956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5306 GLEN FOREST DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296076106",
            "telephone_number": "321-446-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 THE PKWY STE J",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296505205",
            "telephone_number": "864-244-3474",
            "fax_number": "864-244-3475"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 W 10th St",
            "address_purpose": "LOCATION",
            "city": "Lynn Haven",
            "state": "FL",
            "postal_code": "324442329",
            "country_code": "US",
            "telephone_number": "850-815-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCE",
        "first_name": "MIRANDA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-11",
        "last_updated": "2022-08-22",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "7731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2022; 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.