Look up the most recent NPI and PECOS records

Renee May Sayson Miranda

Family Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

This provider is enrolled in PECOS as RENEE MIRANDA.

Based on the most recent information from CMS, provider Renee May Sayson Miranda is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1154740454
Provider Type
Individual
Full Name
Miranda, Renee May Sayson
Title
Dr.
Credential
M.D.

Gender
Female
Sole Proprietor
No
Enumeration Date
4/15/2014
Last Updated
1/23/2024

Contact Information

Practice Location

102 E Ravine Rd, Kingsport, TN 37660

(423) 245-9600

(423) 245-9634

Mailing Location

PO Box 699, Mountain Home, TN 37684-0699

(423) 433-6039

(423) 433-6060

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 58998 Tennessee
Code 207P00000X	Description Emergency Medicine Allopathic & Osteopathic Physicians	License 0101261914 Virginia
Code 207Q00000X	Description Family Medicine Allopathic & Osteopathic Physicians	License 35130444 Ohio

Provider Identifiers

ID	Description	Issuer
ID Q047981	Description Medicaid	Issuer Unlisted Tennessee

Renee May Sayson Miranda

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Hicks, Mack L

Sumpter, Zachary Linuel

Fore, Edward Johnson

Robbins, Sherry L

Brummel, Mark

Stirman, Edward Monty

Mclain, Scott D

Mccoy, James

Switalski, Remigiusz Jan

Casey, Gary Q