Organization Active NPI

Sheila L Miranda MD Professional Corporation

  • Internal Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1770504664
Registry record updated May 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11089 Issued in NV
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

Updated by the provider on May 28, 2015

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)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1770504664OtherGROUP NPI
1770504664OtherNVNPI GROUP
100504137MedicaidNV

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.