MRS. MIRANDA DESHAWNA THOMAS (NPI# 1629495247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629495247 |
| Entity Type | Individual |
| Full Name | MRS. MIRANDA DESHAWNA THOMAS |
| Credential | FNP |
| Practice Address |
4485 W Stone Dr Suite 200 Kingsport TN 37660-1050 |
| Mailing Address |
105 W Stone Dr Suite 6a Kingsport TN 37660-3365 |
| Practice Telephone | 4232243150 |
| Practice Fax Number | 4232243169 |
| Mailing Telephone | 4234087220 |
| Mailing Fax Number | 4234087405 |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2016-08-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
21526 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024171552 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669090569 | Miranda Thomas | Pharmacist | 1906 Belleview Ave Se, Roanoke, VA 24014-1838 | 2020-07-08 |
| 1356974307 | Miranda Thomas | Behavior Technician | 1045 Kilauea Ave Ste A, Hilo, HI 96720-4291 | 2020-02-18 |
| 1417594599 | Miranda Thomas | Nurse Practitioner | 1590 Freedom Blvd Ste B, Florence, SC 29505-6071 | 2019-12-08 |
| 1427512318 | Miranda Lynn Thomas | Nurse Practitioner | 11110 Medical Campus Rd Ste 228, Hagerstown, MD 21742-6727 | 2019-01-25 |
| Street Address |
4485 W STONE DR SUITE 200 |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37660-1050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144297946 | Asheesh Shipstone | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2006-03-01 |
| 1730655671 | Misty Dawn Dockery | Nurse Practitioner | 4485 W Stone Dr, Kingsport, TN 37660-1487 | 2018-10-18 |
| 1770095762 | Jennifer Leigh Cox | Registered Nurse | 4485 W Stone Dr, Kingsport, TN 37660-1487 | 2017-10-30 |
| 1043769490 | Jessica N Bembry | Registered Nurse | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2016-09-27 |
| 1104286194 | Wellmont Medical Associates, Inc. | Clinical Medical Laboratory | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2016-03-03 |
| 1760861140 | Mistie Hagaman | Nurse Practitioner | 4485 W Stone Dr, Kingsport, TN 37660-1487 | 2015-05-19 |
| 1235543380 | Paige M Goforth | Physician Assistant | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2014-06-17 |
| 1164720793 | Nancy Smith | Nurse Practitioner | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2011-03-07 |
| 1750519856 | Nausheen Ahmed | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2009-06-26 |
| 1205016060 | Jamal Gerges Maatouk | Internal Medicine | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 | 2007-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750909891 | Nancy Gober | Pharmacist | Holston Valley Medical Center Inpatient Pharmacy, 130 W Ravine, Kingsport, TN 37660 | 2020-07-06 |
| 1700437621 | Tammy Denise Leblanc | Technician | 125 Lancer Rd, Kingsport, TN 37660 | 2019-09-23 |
| 1831743392 | Independent Physical Therapy | Occupational Therapist | 1704 E. Stone Dr. Ste 120, Kingsport, TN 37660 | 2019-08-01 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1053813527 | Pulitzer Orthodontics, LLC | Dentist | 1200 Pulitzer Place, Kingsport, TN 37660 | 2018-03-01 |
| 1174038749 | Sbh-kingsport | Psychiatric Hospital | 1025 Executive Park Blvd, Kingsport, TN 37660 | 2017-12-05 |
| 1548771447 | Sara B Ball | Registered Nurse | 111 W Stone Dr Ste 240, Kingsport, TN 37660 | 2017-10-18 |
| 1821525361 | Ashley Brook Weems | Nurse Practitioner | Six Sheridan Square Suite 100, Kingsport, TN 37660 | 2017-05-15 |
| 1639625643 | Stephanie H Garris | Nurse Practitioner | 117 W Sevier Ave Ste 120, Kingsport, TN 37660 | 2016-08-30 |
| 1073965679 | Teresa Anne Starke | Physician Assistant | 8 Sheridan Square, Suite 110, Kingsport, TN 37660 | 2016-07-07 |
| Find all providers in zip 37660 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750911202 | Felicia Grace Berry | Nurse Practitioner | 2204 Pavilion Dr Ste 210, Kingsport, TN 37660-4652 | 2020-01-23 |
| 1205399508 | Michael David Thacker | Nurse Practitioner | 100 Clinchfield St, Kingsport, TN 37660-3681 | 2019-04-12 |
| 1871058263 | Lisa Marie Ketchem | Nurse Practitioner | 5039 Andrew St, Kingsport, TN 37660-6500 | 2019-02-10 |
| 1972067395 | Alice Victoria Lilly | Nurse Practitioner | 2995 Ft. Henry Drive, Suite 100, Kingsport, TN 37664 | 2019-01-30 |
| 1720542376 | Amanda Michelle Oliver | Nurse Practitioner | 404 Manor Dr Apt F, Kingsport, TN 37660-3471 | 2019-01-29 |
| 1750857439 | Ashlee Fleming | Nurse Practitioner | 105 W Stone Dr Ste 4c, Kingsport, TN 37660-3365 | 2018-10-19 |
| 1497220214 | Melanie Creppel Bourgeois | Nurse Practitioner | 4606 Sundown Dr, Kingsport, TN 37664-6913 | 2018-10-08 |
| 1013493147 | Cathy A Greenwood | Nurse Practitioner | 3136 Winesap Rd, Kingsport, TN 37663-2920 | 2018-07-11 |
| 1871095315 | Macie Anderson | Nurse Practitioner | 411 Clay St, Kingsport, TN 37660 | 2018-03-01 |
| 1235641630 | Bethany Monique Rock | Nurse Practitioner | 3716 Thorngrove Dr, Kingsport, TN 37660-2243 | 2017-10-26 |
| Find all providers in KINGSPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.