Miracles in a Bag

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

1000000010607 Issued in TN

Legal business name

MIRACLES IN A BAG

Practice address

320 Old Hickory Blvd Apt 3008
Unit 3008
Nashville, TN 37221-1413

Phone

(615) 944-9851

NPI assigned

Sep 21, 2012

Organization subpart

Yes

Parent organization

MIRACLE IN A BAGAs reported in NPPES

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

Authorized official

Name

Ms. Jerrilyn M Boyd-Hadley I, LLC

Title

Owner Ceo

Phone

(615) 944-9851

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• None Former legal business name

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1902157605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 OLD HICKORY BLVD APT 3008",
            "address_2": "UNIT 3008",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372211413",
            "telephone_number": "615-944-9851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 OLD HICKORY BLVD APT 3008",
            "address_2": "UNIT 3008",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372211413",
            "telephone_number": "615-944-9851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLES IN A BAG",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIRACLE IN A BAG",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "BOYD-HADLEY",
        "authorized_official_first_name": "JERRILYN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "615-944-9851",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "LLC"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "TN",
            "license": "1000000010607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "301400000X",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "None",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Minuteclinic Diagnostic of Tennessee PC
• Minuteclinic Diagnostic of Tennessee PC
• Minuteclinic Primary Care Tennessee PLLC
• Jacqueline Angella Minzie-Bailey, RPH
• Claire Mipro
• Connie Jaqueline Miranda, MD
• Fernando T Miranda, MD
• Ryan D Mire, M.D.
• Miriam'S Promise
• Muhammad Bilal Mirza, MD

• Health Maintenance Organization in Nashville, TN
• Providers in Nashville, TN by specialty
• Health Maintenance Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.