Jennifer Grace Miranda, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

6577 Issued in SC

Practice address

1795 Dr Frank Gaston Blvd
Rock Hill, SC 29732-1190

Phone

(803) 326-3500

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collective Therapy CorpGroup PAC ID 0143651802, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Collective Therapy Corp.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1396380911

  SC

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1992424071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 AVERY JONES LN APT 308",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297300162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1795 DR FRANK GASTON BLVD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321190",
            "telephone_number": "803-326-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JENNIFER",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "6577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindful Management LLC
• Mindful Missions of SC (Mindful Missions of SC NonProfit)
• Mindful Missions of SC Inc (Mindful Missions of NC)
• Mindfulness Counseling LLC
• Chabre Mingo, LCAS-A
• Miriam Medical Clinic LLC
• April Mitchell
• De'Asia Mitchell
• John E Mitchell, M.D.
• Justin Douglas Mitchell, PT

• Occupational Therapist in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.