Individual provider Active NPI

Miranda Christine Ogden, RN, MSN, NP-C

  • Family Nurse Practitioner
  • Idaho Falls, ID
National Provider Identifier
1871092155
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
57772 Issued in ID
Practice address
2680 Channing Way
Idaho Falls, ID 83404-7517
Phone
(208) 523-7667
NPI assigned
Feb 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 57772 ID Primary

Addresses

Primary practice location

2680 Channing Way
Idaho Falls, ID 83404-7517

Mailing address

1067 W 125 S
Blackfoot, ID 83221-6058
Phone (208) 317-6285

Other practice location 1

3830 S 25th E Ste 300
Idaho Falls, ID 83404-4975
Phone (208) 360-0861

Other practice location 2

1995 E 17th St Ste 1
Idaho Falls, ID 83404-6493
Phone (208) 357-9193

Other names 1

  • Miranda Christine Jarman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190322000201 ID Practitioner - Nurse Practitioner 2769722198 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Oct 9, 2018 Accepting new patients
Community Care PLLC Past Accepting new patients
American Hearing Care Regional Hearing and Balance Center Corp Past Accepting new patients
Mountain Falls Quick Care Past Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients
Community Care, PLLC Past Accepting new patients

Locations

1443 Parkway Dr
Ste C
Blackfoot, ID 83221
Phone (208) 785-2453

1443 Parkway Dr
Ste 4
Blackfoot, ID 83221
Phone (208) 523-7667

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2680 Channing Way
Idaho Falls, ID 83404
Phone (208) 522-4026

32 Madison Professional Park
Rexburg, ID 83440
Phone (208) 356-0766

404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770

Interoperability endpoints

  • Direct secure messaging: miranda.ogden@486851367337988.direct.elationemr.com

Organizations & group practices 6

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": "1517443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1871092155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 W 125 S",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832216058",
            "telephone_number": "208-317-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047517",
            "telephone_number": "208-523-7667"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3830 S 25th E Ste 300",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834044975",
            "country_code": "US",
            "telephone_number": "208-360-0861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1995 E 17th St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834046493",
            "country_code": "US",
            "telephone_number": "208-357-9193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OGDEN",
        "first_name": "MIRANDA",
        "middle_name": "CHRISTINE",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-01",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "57772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "JARMAN",
            "middle_name": "CHRISTINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.