Tamara R Miracle, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2003011632 Issued in MO

Practice address

1 Hospital Dr
Columbia, MO 65212-0001

Phone

(573) 884-4400

Fax

(573) 884-5994

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Curators of the University of Missouri

  • Community/Retail Pharmacy
  • Jefferson City, MO
  • NPI 1740083641
  NPD (past)
• New Century Emergency Physician of West Virginia Inc

  • Emergency Medicine Physician
  • Charleston, WV
  • NPI 1396722641

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1861446445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843966",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641843966",
            "telephone_number": "573-884-3300",
            "fax_number": "573-884-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652120001",
            "telephone_number": "573-884-4400",
            "fax_number": "573-884-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "TAMARA",
        "middle_name": "R",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2003011632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hailey Leanne Milne
• Mind Matters LLC
• Michael Lee Minten Sr., DDS
• Laurie Beth Mintz, PHD
• Junaid Subhani Mir, M.D.
• Jonathan Thomas Misch, MD
• Zubin Mishra
• Marianne J Misiewicz, DPM
• Madhukar Misra, M.D.
• Shamita Misra, M.D.

• Physician Assistant in Columbia, MO
• Providers in Columbia, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.