Miranda M Schoenecker, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2406-023 Issued in WI

Practice address

3520 Tower Ave
Superior, WI 54880-5335

Phone

(715) 392-9711

NPI assigned

Jul 22, 2009

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 WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1248220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248220800000",
    "number": "1992935126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 E 1ST ST",
            "address_2": "APT 1224C",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052444",
            "telephone_number": "651-343-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 TOWER AVE",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548805335",
            "telephone_number": "715-392-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENECKER",
        "first_name": "MIRANDA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-22",
        "last_updated": "2009-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "2406-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cord Thomas Salmela, PA-C
• Melony Sasser
• Nichelle Schloemer, PHARMD
• Molly Danforth Schmidt, PHARMD
• Emma Schmit
• Donna Marie Schroeder, DDS
• Pamela S. Schwartau, CFNP
• Amanda Grayce Schwartz, DMD
• Ronald Kent Scott, DDS
• Paul Jay Seese II, RN

• Medical Physician Assistant in Superior, WI
• Providers in Superior, WI by specialty
• Medical Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.