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Mini Miracles Pediatric Therapy, Pllc

Early Intervention Provider Agency in Johnson City, TN · enumerated 2013 · authorized official Douglas Brown, Ceo/Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1477991560

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Registry record

Entity type Organization (Type 2)
Legal business name Mini Miracles Pediatric Therapy, Pllc
Practice address 2214 E Fairview Ave, Johnson City, TN, 37601
Fax (423) 232-7970
Enumeration date Jun 11, 2013
Last updated in NPPES Oct 3, 2023

Taxonomy & classification

251C00000X Developmentally Disabled Services Day Training Agency Agencies · License 0119003962 (VA) Secondary
252Y00000X Early Intervention Provider Agency Agencies · License 4611 (VA) Primary

Authorized official

Name Douglas Brown
Title Ceo/Owner

Other identifiers

Identifier Type State Issuer
1477991560 Medicaid VA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Mini Miracles Pediatric Therapy, Pllc located?
The practice location on file with NPPES is in Johnson City, TN.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2023-10-03. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-10-03.