Miranda Lee Goforth, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

218923 Issued in AR

Practice address

146 Passion Play Rd Ste a
Eureka Springs, AR 72632-9455

Phone

(479) 253-9746

NPI assigned

Jun 7, 2010

Last updated

Jun 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Miranda Lee Johnson Former name

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: miranda.goforth.1@14940.direct.athenahealth.com
• Direct secure messaging: mirandagoforth@wrms.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Washington Regional Medical System

  dba Washington Regional Family Clinic Eureka Springs

  • Family Medicine Physician
  • Eureka Springs, AR
  • NPI 1437102662
  Medicare reassignment NPD
• Washington Regional Medical System

  dba Washington Regional Family Clinic - Farmington

  • Family Medicine Physician
  • Farmington, AR
  • NPI 1275839011
  NPD

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

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1891015467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 PASSION PLAY RD STE A",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726329455",
            "telephone_number": "479-253-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 PASSION PLAY RD STE A",
            "city": "EUREKA SPRINGS",
            "state": "AR",
            "postal_code": "726329455",
            "telephone_number": "479-253-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFORTH",
        "first_name": "MIRANDA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-07",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "15025",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "218923",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R874514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "JOHNSON",
            "middle_name": "LEE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eureka Springs Hospital Family Clinic LLC
• Eureka Springs Public Schools
• Ladenna Alice Evans
• Jason Froeschle
• Francesca Ann Garcia Giri, L.AC
• Sarah Williams Gorrell, MSW, LCSW
• Jillian Guthrie, LCSW
• Lee M Harvill, CCC-SLP
• Shelley Lynn Harvill, MHPP
• Stephen Andrew Hearn, PT, DPT, ACNP, APRN

• Family Nurse Practitioner in Eureka Springs, AR
• Providers in Eureka Springs, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.