Active NPI
Kasey Anne Miranda, PTA
- Physical Therapy Assistant
- Iola, KS
National Provider Identifier
1639823339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA9427
- Practice address
- 600 E Garfield St
Iola, KS 66749-2034 - Phone
- (620) 365-3183
- NPI assigned
- Feb 10, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 14-03957 | KS | |
| Physical Therapy Assistant | 225200000X | PTA9427 | AL | Primary |
Addresses
Primary practice location
600 E Garfield St
Iola, KS 66749-2034
Mailing address
1112 Colonial Dr
Alabaster, AL 35007-8001
Phone (205) 902-9431
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| EDU837505499 | Other | AL | BCBS PEEHIP |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA9427 | AL | MD | Physical Therapy Assistant |
| 14-03957 | KS | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644451200000",
"number": "1639823339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1112 COLONIAL DR",
"city": "ALABASTER",
"state": "AL",
"postal_code": "350078001",
"telephone_number": "205-902-9431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E GARFIELD ST",
"city": "IOLA",
"state": "KS",
"postal_code": "667492034",
"telephone_number": "620-365-3183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "KASEY",
"middle_name": "ANNE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-10",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "KS",
"license": "14-03957",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "PTA9427",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PEEHIP",
"identifier": "EDU837505499",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Iola, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.