Miranda Shoemaker (NPI# 1205318011, PAC ID# 3779837448) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICAL THERAPY.
| Nation Provider ID (NPI) | 1205318011 |
| PAC ID by PECOS | 3779837448 |
| Professional Enrollment ID | I20181115001253 |
| Full Name | Miranda Shoemaker |
| Organization Legal Name | AGAVE PHYSICAL THERAPY LLC |
| Address |
191 Swanson Ave Suite 102 Lake Havasu City AZ 86403-6699 |
| Phone Number | 9288557880 |
| Gender | F |
| Graduation Year | 2018 |
| Primary Specialty | PHYSICAL THERAPY |
| Group Practice PAC ID | 2163705799 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 191 Swanson Ave, Suite 102, Lake Havasu City, AZ 86403-6699 | 9288557880 | AGAVE PHYSICAL THERAPY LLC |
| Organization Legal Name | AGAVE PHYSICAL THERAPY LLC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brett Qualls | Physical Therapy | Agave Physical Therapy LLC | 191 Swanson Ave, Suite 102, Lake Havasu City, AZ 86403-6699 |
| Tamra J Coleman | Physical Therapy | Agave Physical Therapy LLC | 191 Swanson Ave, Lake Havasu City, AZ 86403-6699 |
| Street Address |
191 SWANSON AVE SUITE 102 |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip | 86403-6699 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brett Qualls | Physical Therapy | Agave Physical Therapy LLC | 191 Swanson Ave, Suite 102, Lake Havasu City, AZ 86403-6699 |
| Tamra J Coleman | Physical Therapy | Agave Physical Therapy LLC | 191 Swanson Ave, Lake Havasu City, AZ 86403-6699 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Essa J Sidiqi | Family Medicine | Lake Havasu Primary Care Pllc | 89 Civic Ctr Ln, Lake Havasu City, AZ 86403-0810 |
| Harley Finkle | Chiropractic | 1674 Mcculloch Blvd N, Lake Havasu City, AZ 86403-0962 | |
| Mary Ann Widman | Nurse Practitioner | Hrmc, LLC | 1799 Kiowa Ave, Suite 104, Lake Havasu City, AZ 86403-2867 |
| Paul E Klein | Nurse Practitioner | Hrmc, LLC | 1799 Kiowa Ave, Suite 104, Lake Havasu City, AZ 86403-2867 |
| Annette Baccus | Nurse Practitioner | Havasu Regional Medical Center LLC | 1799 Kiowa Ave, Suite 104, Lake Havasu City, AZ 86403-2867 |
| Christian L Grandell | Physician Assistant | Fps Medical Center Ltd | 1720 Mesquite Ave, Suite 100, Lake Havasu City, AZ 86403-5602 |
| Peter H Dux | Family Medicine | Fps Medical Center Ltd | 1720 Mesquite Ave, Suite 100, Lake Havasu City, AZ 86403-5602 |
| Jeffrey J Carls | Family Medicine | Fps Medical Center Ltd | 1720 Mesquite Ave, Suite 100, Lake Havasu City, AZ 86403-5602 |
| Lisa V Williams | Physician Assistant | Fps Medical Center Ltd | 1720 Mesquite Ave, Suite 100, Lake Havasu City, AZ 86403-5602 |
| Bridget C Conley | Physician Assistant | Fps Medical Center Ltd | 1720 Mesquite Ave, Suite 100, Lake Havasu City, AZ 86403-5602 |
| Find all physicians in zip 86403 | |||
| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
| Specialty | PHYSICAL THERAPY |
| City + Specialty | LAKE HAVASU CITY + PHYSICAL THERAPY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.