Miranda Ellisa Baumguardner, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP137886 Issued in TX

Practice address

500 W 4TH St
Odessa, TX 79761-5001

Phone

(432) 640-1883

Fax

(432) 640-2428

NPI assigned

Aug 28, 2019

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)

Enrolled

State licenses

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666828800000",
    "number": "1730737214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797615001",
            "telephone_number": "432-640-1883",
            "fax_number": "432-640-2428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGUARDNER",
        "first_name": "MIRANDA",
        "middle_name": "ELLISA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2022-10-27",
        "certification_date": "2022-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP137886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Basin Orthopedic Surgical Specialists, P.a.
• Basin Orthotic & Prosthetic Center PLLC
• Basin Podiatry P a
• Alexander Andres Bastidas Palacios, M.D.
• Kenneth H. Batch, M.D.
• Tamara Rachelle Bavousett, RN, C-PNP
• Kendra Ann Baxter, MS.CCC/SLP
• William Jesse Baxter, D.D.S.
• Gerald Ray Beaty, DC
• Hannah Elaine Beaver, LM CPM

• Family Nurse Practitioner in Odessa, TX
• Providers in Odessa, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.

Verify at the official NPI Registry.