Active NPI
Miranda Joann Watford
- Physical Therapy Assistant
- Midwest City, OK
National Provider Identifier
1780297937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 3272
- Practice address
- 1400 Buena Vista Ave
Midwest City, OK 73110-2604 - Phone
- (405) 251-9988
- NPI assigned
- Aug 27, 2020
- Last updated
- Aug 27, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3272 | OK | Primary |
Addresses
Primary practice location
1400 Buena Vista Ave
Midwest City, OK 73110-2604
Mailing address
3700 12TH Ave SE Apt 511
Norman, OK 73072-8323
Phone (140) 556-7705
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3272 | OK | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1780297937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 12TH AVE SE APT 511",
"city": "NORMAN",
"state": "OK",
"postal_code": "730728323",
"telephone_number": "140-556-7705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 BUENA VISTA AVE",
"city": "MIDWEST CITY",
"state": "OK",
"postal_code": "731102604",
"telephone_number": "405-251-9988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATFORD",
"first_name": "MIRANDA",
"middle_name": "JOANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-27",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OK",
"license": "3272",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midwest City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.