Individual provider Active NPI

Miranda Weber, FNP

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1912383985
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F06151472 Issued in MO
Practice address
11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone
(314) 653-5000
NPI assigned
Jul 31, 2015
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F06151472 MO Primary
Nurse Practitioner 363L00000X F06151472 MO

Addresses

Primary practice location

11133 Dunn Rd
Saint Louis, MO 63136-6163

Mailing address

9556 Manchester Rd
Saint Louis, MO 63119-1313

Other names 1

  • Miranda Griffey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20151111001700 MO Practitioner - Nurse Practitioner 3476863077 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital LincolnGroup PAC ID 5193040020, 31 clinicians

Practice addresses (Care Compare)

1000 E Cherry St
Mercy Emergency Department
Troy, MO 63379-1513
Phone (636) 528-3221

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F06151472MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hermann Area Hospital District CurrentSince Sep 19, 2017 Accepting new patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Oct 27, 2015 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jul 8, 2024 Accepting new patients
Hermann Area Hospital District CurrentSince Sep 19, 2017 Accepting new patients
Mercy Hospital Lincoln CurrentSince Jul 8, 2024 Accepting new patients

Locations

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1225 Graham Rd
Florissant, MO 63031
Phone (314) 653-5630

509 W 18th St
Hermann, MO 65041
Phone (573) 486-2045

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

1000 E Cherry St
Troy, MO 63379
Phone (636) 528-3327

900 E Cherry St
Troy, MO 63379
Phone (636) 528-8585

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/f62890b5-77ff-44bd-a981-0a0981047b35/

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1912383985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9556 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11133 DUNN RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631366163",
            "telephone_number": "314-653-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "MIRANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-31",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F06151472",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "F06151472",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIRANDA",
            "last_name": "GRIFFEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.