Individual provider Active NPI

Erin Miksic, CNM

  • Advanced Practice Midwife
  • Manor, TX
National Provider Identifier
1689004574
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP134661 Issued in TX
Practice address
14008 Shadowglen Blvd Ste 302
Manor, TX 78653-3406
Phone
(512) 445-4800
Fax
(512) 308-9649
NPI assigned
Nov 14, 2013
Last updated
Feb 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 001574 NY
Advanced Practice Midwife 367A00000X AP60643407 WA
Advanced Practice Midwife 367A00000X AP134661 TX Primary

Addresses

Primary practice location

14008 Shadowglen Blvd Ste 302
Manor, TX 78653-3406

Mailing address

14008 Shadowglen Blvd Ste 302
Manor, TX 78653-3406
Phone (512) 445-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190102002300 TX Practitioner - Certified Nurse Midwife (CNM) 3274764014 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
001574NYMDAdvanced Practice Midwife
AP60643407WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. CurrentSince Mar 24, 2021 Accepting new patients
Randall Burt MD PA Current Accepting new patients
Lone Star Circle of Care CurrentSince Oct 1, 2022 Accepting new patients
Steven R. Macdonald, M.D., P.a. Current Accepting new patients
Lone Star Circle of Care CurrentSince Oct 1, 2022 Accepting new patients
Lone Star Circle of Care Current Accepting new patients

Locations

1221 W Ben White Blvd
Ste 200B
Austin, TX 78704
Phone (512) 524-9249

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

2423 Williams Dr
Georgetown, TX 78628
Phone (512) 686-0207

6124 W Parker Rd
Ste 134
Plano, TX 75093
Phone (972) 981-7777

Interoperability endpoints

  • Direct secure messaging: erin.miksic.2@11541.direct.athenahealth.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1689004574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14008 SHADOWGLEN BLVD STE 302",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786533406",
            "telephone_number": "512-445-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14008 SHADOWGLEN BLVD STE 302",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786533406",
            "telephone_number": "512-445-4800",
            "fax_number": "512-308-9649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKSIC",
        "first_name": "ERIN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-14",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "001574",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP60643407",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "AP134661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manor, TX

Sources for this page

Verify at the official NPI Registry.