Miranda Patterson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH13432 Issued in FL

Practice address

769 Kenowood Dr
Port Orange, FL 32129-4266

Phone

(704) 438-2895

NPI assigned

Feb 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edgewater Chiropractic Clinic, P.a.

  • Chiropractor
  • Edgewater, FL
  • NPI 1821421363
  Medicare reassignment NPD

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614038400000",
    "number": "1801480520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 KENOWOOD DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 KENOWOOD DR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294266",
            "telephone_number": "704-438-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MIRANDA",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH13432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pathways Home Care, LLC
• Patricia Adams Counseling, LLC (Lakeside Counseling and Wellness Center)
• John Walter Patrick, PH.D.
• Cortnee Patterson
• Melissa Anne Patterson
• Rebecca Elaine Patterson, PTA
• Nathan Patton
• Michael Peachman
• Charles Raymond Peacock III, RBT
• Stephanie Alyce Peacock, HAS

• Chiropractor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.