Active NPI
Miranda Elise Holt, PA-C
- Physician Assistant
- Edmond, OK
National Provider Identifier
1881527604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5885
- Practice address
- 608 Liberty LN
Edmond, OK 73034-9432 - Phone
- (405) 657-3436
- NPI assigned
- Jun 3, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5885 | OK | Primary |
Addresses
Primary practice location
608 Liberty LN
Edmond, OK 73034-9432
Mailing address
401 W Covell Rd Apt 221
Edmond, OK 73003-2002
Other names 1
- Miranda Elise Thibodeau
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5885 | OK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788134400000",
"number": "1881527604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 W COVELL RD APT 221",
"city": "EDMOND",
"state": "OK",
"postal_code": "730032002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "608 LIBERTY LN",
"city": "EDMOND",
"state": "OK",
"postal_code": "730349432",
"telephone_number": "405-657-3436"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLT",
"first_name": "MIRANDA",
"middle_name": "ELISE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-03",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "OK",
"license": "5885",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MIRANDA",
"last_name": "THIBODEAU",
"middle_name": "ELISE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Edmond, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.