Ekaterina Mironova, AG-ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

087881-23 Issued in NH

Practice address

15 Tsienneto Rd
Derry, NH 03038-1557

Phone

(603) 537-1300

NPI assigned

Jul 21, 2014

Last updated

Oct 26, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekaterinamironova@dmcnh.allscriptsdirect.net

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.

• Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
  • NPI 1922030493
  NPD
• CH Specialty Services Ma PC

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1902510720
  NPD
• Premier Home Health Agency

  • Home Health Agency
  • Kingman, AZ
  • NPI 1003219007
  NPD (past)

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1740697960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BUTTRICK RD STE 102",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533417",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030381557",
            "telephone_number": "603-537-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRONOVA",
        "first_name": "EKATERINA",
        "name_prefix": "Ms.",
        "credential": "AG-ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MA",
            "license": "RN2329856",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "TAP5715",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NH",
            "license": "087881-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Merritt, CSFA
• Michael R Dion DMD Fagd
• Emma B Michaud, AUD
• Michelle Horan Nutrition and Wellness
• Katelyn Lee Milligan, LMHC
• Robert Miskimen III, DDS, MD
• Derek Mixon, PHARMD
• Crystal Mohrmann
• Bonnie L Montague, M.ED., BCBA
• Angela Moran

• Acute Care Nurse Practitioner in Derry, NH
• Providers in Derry, NH by specialty
• Acute Care Nurse Practitioner in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.