Angel Miracle Care

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

Legal business name

ANGEL MIRACLE CARE

Practice address

621 Vanderbilt Loop
Yaphank, NY 11980-2051

Phone

(516) 265-6525

NPI assigned

Apr 16, 2024

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shakiera Simone BryantNPI 1205129103

Title

Owner

Phone

(516) 265-6525

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shakiera Simone Bryant

  • Licensed Practical Nurse
  • Miller Place, NY
  • NPI 1205129103
  NPD Authorized official

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1831943794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 VANDERBILT LOOP",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119802051",
            "telephone_number": "516-265-6525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 VANDERBILT LOOP",
            "city": "YAPHANK",
            "state": "NY",
            "postal_code": "119802051",
            "telephone_number": "516-265-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL MIRACLE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2025-09-11",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "SHAKIERA",
        "authorized_official_middle_name": "SIMONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-265-6525"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205129103",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Andreotta
• Florence S Barresi, OTR/L
• Jennifer Beaulieu, R.N.
• Neva Bellamy, D.C.P., NPP
• Christine Birben
• Ann Mary Bliss, M.A. CCC SLP

• Licensed Practical Nurse in Yaphank, NY
• Providers in Yaphank, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.