Individual provider Active NPI

Miranda Davis

  • Social Worker
  • Evansville, IN
National Provider Identifier
1982489431
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
415 Mulberry St
Evansville, IN 47713-1230
Phone
(812) 436-4306
NPI assigned
Aug 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

415 Mulberry St
Evansville, IN 47713-1230

Mailing address

415 Mulberry St
Evansville, IN 47713-1230
Phone (812) 436-4306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024003358 IN Practitioner - Clinical Social Worker 6406344977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwestern Behavioral Healthcare IncGroup PAC ID 7315842309, 37 clinicians

Practice addresses (Care Compare)

415 Mulberry St
Evansville, IN 47713-1230
Phone (812) 423-7791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Oct 1, 2025 Accepting new patients
Southwestern Behavioral Healthcare, Inc. CurrentSince Oct 1, 2025 Accepting new patients

Locations

414 SE 4th St
Ste 101
Evansville, IN 47713
Phone (812) 424-4880

415 Mulberry St
Evansville, IN 47713
Phone (812) 436-4232

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1982489431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-436-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 MULBERRY ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477131230",
            "telephone_number": "812-436-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "MIRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.