NPIMap

Organization Active NPI

Meridian Medical Group PC

  • Ambulatory Surgical Clinic/Center
  • Avon, IN
National Provider Identifier
1033167499
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
050037961 Issued in IN
Legal business name
MERIDIAN MEDICAL GROUP PC
Practice address
1115 N Ronald Reagan Pkwy
Suite 347
Avon, IN 46123
Phone
(317) 217-2111
Fax
(317) 217-2110
NPI assigned
May 5, 2006
Last updated
Sep 23, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Authorized official

Name
Robin A Walter
Title
Administrator
Phone
(317) 962-5870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 050037961 IN Primary

Addresses

Primary practice location

1115 N Ronald Reagan Pkwy
Suite 347
Avon, IN 46123

Mailing address

1801 N Senate Blvd
Suite 400
Indianapolis, IN 46202
Phone (317) 962-6300

Other identifiers 1

IdentifierTypeStateIssuer
100380420BMedicaidIN

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/73bc01f5-9bdd-4e4b-ba52-efb00b8cec28/

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222128000000",
    "number": "1033167499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 N SENATE BLVD",
            "address_2": "SUITE 400",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46202",
            "telephone_number": "317-962-6300",
            "fax_number": "317-962-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N RONALD REAGAN PKWY",
            "address_2": "SUITE 347",
            "city": "AVON",
            "state": "IN",
            "postal_code": "46123",
            "telephone_number": "317-217-2111",
            "fax_number": "317-217-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-09-23",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "317-962-5870"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": "050037961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100380420B",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.