NPIMap

Individual provider Active NPI

Miranda Krishna, NP-C

  • Family Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1700314010
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2016041522 Issued in MO
Practice address
225 Physicians Park Ste 400
Poplar Bluff, MO 63901-3923
Phone
(573) 727-5500
Fax
(573) 727-5599
NPI assigned
May 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2012022527 MO
Family Nurse Practitioner 363LF0000X 2016041522 MO Primary

Addresses

Primary practice location

225 Physicians Park Ste 400
Poplar Bluff, MO 63901-3923

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829000413 MO Practitioner - Nurse Practitioner 1254604176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Internal Medicine Associates of Southeast Missouri LLCGroup PAC ID 5991615072, 43 clinicians
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians

Practice addresses (Care Compare)

225 Physicians Park Dr
Suite 400
Poplar Bluff, MO 63901-3923

3100 Oak Grove Rd
Poplar Bluff, MO 63901-1573
Phone (573) 785-7721

Hospital & facility affiliations

  • Amedisys Home Health of Missouri Home health agency, Poplar Bluff, MO, CCN 267151
  • Poplar Bluff Regional Medical Center Hospital, Poplar Bluff, MO, CCN 260119
  • Saint Francis Medical Center Hospital, Cape Girardeau, MO, CCN 260183
  • Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
  • Missouri Delta Medical Center Hospital, Sikeston, MO, CCN 260113

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2012022527MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Francis Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Saint Francis Medical Center Nurse Practitioner CurrentSince Oct 1, 2020 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Butler Physician Services, LLC Nurse Practitioner CurrentSince Jul 23, 2017 Accepting new patients
Saint Francis Medical Center Nurse Practitioner Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000

225 Physicians Park
Ste 400
Poplar Bluff, MO 63901
Phone (573) 785-7721

3100 Oak Grove Rd
Rombauer, MO 63901
Phone (573) 776-2000

Interoperability endpoints

  • Direct secure messaging: mkrishna95796@surescripts.sfmc.net

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1700314010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PHYSICIANS PARK STE 400",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013923",
            "telephone_number": "573-727-5500",
            "fax_number": "573-727-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISHNA",
        "first_name": "MIRANDA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2012022527",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2016041522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.