Active NPI
Sheila L Miranda MD Professional Corporation
- Internal Medicine Physician
- Las Vegas, NV
National Provider Identifier
1770504664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 11089
- Legal business name
- SHEILA L MIRANDA MD PROFESSIONAL CORPORATION
- Practice address
- 9811 W Charleston Blvd
2543
Las Vegas, NV 89117-7528 - Phone
- (702) 949-0885
- Fax
- (702) 951-7579
- NPI assigned
- Jul 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sheila L Miranda, MD
- Title
- Owner
- Phone
- (702) 949-0885
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 11089 | NV | Primary |
Addresses
Primary practice location
9811 W Charleston Blvd
2543
Las Vegas, NV 89117-7528
Mailing address
9811 W Charleston Blvd
Suite 2543
Las Vegas, NV 89117-7528
Phone (702) 256-3637
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770504664 | Other | GROUP NPI | |
| 1770504664 | Other | NV | NPI GROUP |
| 100504137 | Medicaid | NV |
National Provider Directory
National Provider DirectoryLocations
9811 W Charleston Blvd
#2543
Las Vegas, NV 89117
Phone (702) 949-0885
9811 W Charleston Blvd
Ste 2543
Las Vegas, NV 89117
Phone (702) 433-6800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1432771200000",
"number": "1770504664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9811 W CHARLESTON BLVD",
"address_2": "SUITE 2543",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891177528",
"telephone_number": "702-256-3637",
"fax_number": "702-256-3307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9811 W CHARLESTON BLVD",
"address_2": "2543",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891177528",
"telephone_number": "702-949-0885",
"fax_number": "702-951-7579"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SHEILA L MIRANDA MD PROFESSIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-23",
"last_updated": "2015-05-28",
"status": "A",
"authorized_official_last_name": "MIRANDA",
"authorized_official_first_name": "SHEILA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "702-949-0885",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NV",
"license": "11089",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP NPI",
"identifier": "1770504664",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI GROUP",
"identifier": "1770504664",
"state": "NV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100504137",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.