Active NPI
Amber Dawn Miracle
- Behavior Analyst
- Greeley, CO
National Provider Identifier
1740856947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 1300 N 17TH Ave
Greeley, CO 80631-9584 - Phone
- (970) 397-8763
- NPI assigned
- May 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
1300 N 17TH Ave
Greeley, CO 80631-9584
Mailing address
928 12TH St
Greeley, CO 80631-4024
Phone (970) 397-8763
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1740856947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 12TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806314024",
"telephone_number": "970-397-8763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N 17TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806319584",
"telephone_number": "970-397-8763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRACLE",
"first_name": "AMBER",
"middle_name": "DAWN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-05-28",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.