Philip D Meador Jr MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

17395 Issued in NC

Legal business name

PHILIP D MEADOR JR MD PA

Practice address

568 Ruin Creek Rd
Suite 120
Henderson, NC 27536-2880

Phone

(252) 492-2123

Fax

(252) 436-0031

NPI assigned

Jun 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Philip Dale Meador Jr., MD

Title

Physician

Phone

(252) 492-2123

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296777600000",
    "number": "1013119254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD",
            "address_2": "SUITE 120",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362880",
            "telephone_number": "252-492-2123",
            "fax_number": "252-436-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "568 RUIN CREEK RD",
            "address_2": "SUITE 120",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362880",
            "telephone_number": "252-492-2123",
            "fax_number": "252-436-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP D MEADOR JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2011-02-04",
        "status": "A",
        "authorized_official_last_name": "MEADOR",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "252-492-2123",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "17395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8958290",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "58290",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Carole Pernell
• Donna Perry, RN
• James Howard Perry, M.D.
• La'Shanda Michelle Person, LCASA
• Mary Frances Pettway, R.N.
• Eureka Llowanna Phillip, MD
• Emma Phillips, MA
• Piedmont Stone Center
• Jacob Keith Poe, CRNA
• Christopher Talis Porter, LPTA

• Specialist in Henderson, NC
• Providers in Henderson, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.