Individual provider Active NPI

Miranda R McCaskill, AUD

  • Audiologist
  • Vicksburg, MS
National Provider Identifier
1821431990
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A2944 Issued in MS
Practice address
104 McAuley Dr
Vicksburg, MS 39183-2825
Phone
(601) 883-3320
Fax
(601) 883-3326
NPI assigned
Apr 9, 2013
Last updated
Apr 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A2944 MS Primary

Addresses

Primary practice location

104 McAuley Dr
Vicksburg, MS 39183-2825

Mailing address

104 McAuley Dr
Vicksburg, MS 39183-2825
Phone (601) 883-3320

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130522000295 MS Practitioner - Qualified Audiologist 4284872763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vicksburg Clinic LLCGroup PAC ID 5890696330, 27 clinicians

Practice addresses (Care Compare)

2200 Hwy 61 N
Vicksburg, MS 39183-8246

Merit-based Incentive Payment System (MIPS)

Final score
88.07 of 100Reported as apm
Quality
73.89
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A2944MSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Clinic LLC CurrentSince Apr 6, 2013 Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients

Locations

54 Sgt Prentiss Dr
Ste 103
Natchez, MS 39120
Phone (601) 883-5858

104 McAuley Dr
Vicksburg, MS 39183
Phone (601) 638-7271

Interoperability endpoints

  • Direct secure messaging: miranda.mccaskill.1@1475.direct.athenahealth.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1821431990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MCAULEY DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832825",
            "telephone_number": "601-883-3320",
            "fax_number": "601-883-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MCAULEY DR",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832825",
            "telephone_number": "601-883-3320",
            "fax_number": "601-883-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCASKILL",
        "first_name": "MIRANDA",
        "middle_name": "R",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MS",
            "license": "A2944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.