Joanne Lee Miracle, ANP-C; GNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

200050105NP Issued in OR

Practice address

4560 SE International Way Ste 100
Milwaukie, OR 97222-4628

Phone

(971) 206-5179

Fax

(503) 905-0495

NPI assigned

Jun 18, 2006

Last updated

Aug 10, 2020By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Nurse Practitioner

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marquis Clinical Services LLCGroup PAC ID 2860827821, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Marquis Clinical Services LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Milwaukie, OR
  • NPI 1710427810

  Gerontology

  Medicare reassignment Care Compare group NPD
• University Anesthesiology Associates, LLC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1841217817
  NPD
• Joseph P Stapleton MD, PC

  dba Portland Pain Care

  • Pain Medicine (Anesthesiology) Physician
  • Portland, OR
  • NPI 1376728097
  NPD (past)
• Rehab Specialists Outpatient, LLC

  dba AgeRight Therapy Hope Village

  • Clinic/Center
  • Canby, OR
  • NPI 1437019015
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1922043462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5179",
            "fax_number": "503-905-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SE INTERNATIONAL WAY STE 100",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972224628",
            "telephone_number": "971-206-5179",
            "fax_number": "503-905-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRACLE",
        "first_name": "JOANNE",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "ANP-C; GNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200050105NP",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "200050105NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113099",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milwaukie Spine and Sport, LLC
• Milwaukie Urgent Care
• Clark Miner, BS, CADC2, QMHA2,
• Hera Minoza
• Paula Mintun, QMHA PSS CRM
• Elahe Gheisari Mireshghi
• Rozina A Misganaw
• Michael Mishler
• Belinda Misterek, RPH
• Duncan Thomas Mitchell, PT

• Adult Health Nurse Practitioner in Milwaukie, OR
• Providers in Milwaukie, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.