Miranda R McCaskill, AUD

Individual provider Active NPI Audiologist · Vicksburg, MS

NPI 1821431990 · NPPES record last updated Apr 9, 2013

Key facts

NPI
1821431990
Entity type
Individual (NPI type 1)
Primary specialty
Audiologist 231H00000X
License
A2944 (MS)
Practice address
104 McAuley Dr
Vicksburg, MS 39183-2825
Phone
(601) 883-3320
Fax
(601) 883-3326
NPI assigned
Apr 9, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vicksburg Clinic LLC (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 100 (apm)
Quality
73.89
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
A2944MSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vicksburg Clinic LLC Current
since 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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A2944 MS Yes

Addresses

Primary practice location

104 McAuley Dr
Vicksburg, MS 39183-2825

Mailing address

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

Other providers in Vicksburg, MS

All providers in Vicksburg, MS · Audiologist in Mississippi

Sources for this page

Verify at the official NPI Registry.