Individual provider Active NPI

Miranda Patterson Wiggins, CRNP

  • Nurse Practitioner
  • Andalusia, AL
National Provider Identifier
1679847776
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-105034 Issued in AL
Practice address
845 W Bypass Ste D
Andalusia, AL 36420-4748
Phone
(334) 305-2800
Fax
(334) 305-2801
NPI assigned
Mar 7, 2012
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-105034 AL Primary

Addresses

Primary practice location

845 W Bypass Ste D
Andalusia, AL 36420-4748

Mailing address

118 Obrannan Park Dr
Dothan, AL 36303-2052
Phone (334) 305-2800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120808000762 AL Practitioner - Nurse Practitioner 7315193208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rao Heart and Vascular LLCGroup PAC ID 1557769726, 7 clinicians

Practice addresses (Care Compare)

612 N Main St
Suite B
Enterprise, AL 36330-1775
Phone (334) 305-2800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-105034ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Dermatology Group PA CurrentSince Jul 1, 2023 Accepting new patients
Rao Heart & Vascular LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

845 W Bypass
Ste D
Andalusia, AL 36420
Phone (334) 305-2800

847 W Bypass
Ste J
Andalusia, AL 36420
Phone (334) 305-2800

112 Haven Dr
Ste 1
Dothan, AL 36301
Phone (334) 673-0049

200 Medical Care Way
Dothan, AL 36303
Phone (334) 305-2800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GAGFCD
  • Direct secure messaging: miranda.wiggins.1@5021.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1679847776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 OBRANNAN PARK DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032052",
            "telephone_number": "334-305-2800",
            "fax_number": "866-554-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 W BYPASS STE D",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364204748",
            "telephone_number": "334-305-2800",
            "fax_number": "334-305-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "MIRANDA",
        "middle_name": "PATTERSON",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-07",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-105034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

Verify at the official NPI Registry.