Individual provider Active NPI

Dawn Chavez Miranda, COTA

  • Occupational Therapy Assistant
  • Las Cruces, NM
National Provider Identifier
1922291350
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1066 Issued in NM
Practice address
301 Perkins Dr Ste B
Las Cruces, NM 88005-3248
Phone
(505) 523-7243
Fax
(505) 523-7254
NPI assigned
Aug 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1066 NM Primary

Addresses

Primary practice location

301 Perkins Dr Ste B
Las Cruces, NM 88005-3248

Mailing address

3057 Executive Hills Rd
Las Cruces, NM 88011-4717
Phone (505) 521-3471

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

LicenseStateTypeSpecialty
1066NMMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1922291350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3057 EXECUTIVE HILLS RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880114717",
            "telephone_number": "505-521-3471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 PERKINS DR STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053248",
            "telephone_number": "505-523-7243",
            "fax_number": "505-523-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "DAWN",
        "middle_name": "CHAVEZ",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "1066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2007; 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.