Miracles Network Agency

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

0298258 Issued in TN

Legal business name

MIRACLES NETWORK AGENCY

Practice address

615 Sugg PL
Dyersburg, TN 38024-3052

Phone

(731) 285-6499

NPI assigned

Nov 8, 2011

Organization subpart

No

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

Authorized official

Name

Andrea Lo

Title

Executive Director

Phone

(731) 285-6499

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356480000000",
    "number": "1992082788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 SUGG PL",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243052",
            "telephone_number": "731-285-6499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 SUGG PL",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380243052",
            "telephone_number": "731-285-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLES NETWORK AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2012-12-26",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "731-285-6499"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "TN",
            "license": "0298258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H60",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MH Health Care Services, PC
• Michael E. Steuer, MD, PC
• Mid-South Convenient Care, PLLC
• Mid-South Retina Associates, LLC
• Karen Milliner, PSY.D
• Janet S.. Monroe, R.N.
• Molly Moody, SLP
• Donna K Moore
• Leslie Corinne Moore, LPC
• Olyn Fred Moore III, MD

• Exclusive Provider Organization in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Exclusive Provider Organization in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.