Miranda E Blevins, MD
Individual provider Active NPI Emergency Medicine Physician · Newburgh, IN
NPI 1962630574 · NPPES record last updated Jun 23, 2022
Key facts
- NPI
- 1962630574
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 01072349A (IN)
- Practice address
- 4015 Gateway Blvd
Newburgh, IN 47630-8925 - Phone
- (812) 858-9400
- Fax
- (812) 858-9571
- NPI assigned
- Jun 23, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wabash General Hospital District
Practice addresses (Care Compare)
1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 262-8621
Hospital & facility affiliations
- Wabash General Hospital 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN, IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130528000653 | IN | Practitioner - Emergency Medicine |
3375792146 | Reassigns benefits to 2 organizations |
| I20200121002206 | IL | Practitioner - Family Practice | 3375792146 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Professionals of Indiana, P.C. | Emergency Medicine | Current |
Accepting new patients |
| Wabash General Hospital District | Current |
Accepting new patients | |
| Cep America LLC | Emergency Medicine | Current |
Accepting new patients |
| Cep America LLC | Emergency Medicine | Current | Accepting new patients |
| Wabash General Hospital District | Current |
Accepting new patients | |
| Cep America LLC | Emergency Medicine | Current |
Accepting new patients |
| Wabash General Hospital District | Current | Accepting new patients | |
| Richland Memorial Hospital, Inc | Current | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621
900 E Scott St
Olney, IL 62450
Phone (618) 345-1000
800 E Locust St
Olney, IL 62450
Phone (618) 395-2131
1116 Millis Ave
Boonville, IN 47601
Phone (812) 897-4800
3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021
1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523
Interoperability endpoints
- mblevinsmd306111@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 01072349A | IN | |
| Emergency Medicine Physician | 207P00000X | 01072349A | IN | Yes |
Addresses
Primary practice location
4015 Gateway Blvd
Newburgh, IN 47630-8925
Mailing address
PO Box 1510
Evansville, IN 47706-1510
Phone (812) 450-6815
Other names
- Miranda E Wire
Other providers in Newburgh, IN
- Elizabeth Blackford
- Anna Nicole Blalock
- Jessica Ann Blandford
- Nathan Thomas Blandford
- Megan Marie Blankenberger
- Board of Trustees of Welborn Clinic
- Board of Trustees of Welborn Clinic
- Board of Trustees of Welborn Clinic
- Board of Trustees of Welborn Clinic
- Board of Trustees of Welborn Clinic
All providers in Newburgh, IN · Emergency Medicine Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.