Miranda Montgomery, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

14000073051 Issued in NY

Practice address

240 W Seneca St Ste 3
Manlius, NY 13104-2451

Phone

(315) 682-2025

Fax

(315) 682-2756

NPI assigned

Jan 16, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1699536805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W SENECA ST STE 3",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042451",
            "telephone_number": "315-682-2025",
            "fax_number": "315-682-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W SENECA ST STE 3",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131042451",
            "telephone_number": "315-682-2025",
            "fax_number": "315-682-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "MIRANDA",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-16",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NY",
            "license": "14000073051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing Instrument Specialist in Manlius, NY
• Providers in Manlius, NY by specialty
• Hearing Instrument Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.