Individual provider Active NPI

Miranda Lee Brown, LPN

  • Licensed Practical Nurse
  • Saint Clairsville, OH
National Provider Identifier
1811344617
Registry record updated May 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
130042 Issued in OH
Practice address
67670 Traco Dr
Saint Clairsville, OH 43950-9375
Phone
(740) 695-2131
Fax
(740) 695-7140
NPI assigned
May 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 130042 OH Primary

Addresses

Primary practice location

67670 Traco Dr
Saint Clairsville, OH 43950-9375

Mailing address

225 Petrick Ave
Mingo Junction, OH 43938-1533
Phone (740) 502-0059

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

LicenseStateTypeSpecialty
130042OHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Fox Run Hospital Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463788800000",
    "number": "1811344617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 PETRICK AVE",
            "city": "MINGO JUNCTION",
            "state": "OH",
            "postal_code": "439381533",
            "telephone_number": "740-502-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67670 TRACO DR",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439509375",
            "telephone_number": "740-695-2131",
            "fax_number": "740-695-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MIRANDA",
        "middle_name": "LEE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-21",
        "last_updated": "2016-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "130042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2016; 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.