Meridian Health Plan of Michigan, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

MERIDIAN HEALTH PLAN OF MICHIGAN, INC.

Practice address

777 Woodward Ave Ste 600
Detroit, MI 48226-3589

Phone

(888) 773-2647

NPI assigned

Aug 5, 2019

Organization subpart

Yes

Parent organization

WELLCARE OF MICHIGAN HOLDING COMPANYAs reported in NPPES

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

Authorized official

Name

Michael W Haber

Title

Vice President, Secretary

Phone

(813) 206-3252

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Meridian Health Plan of Michigan2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Meridian Health Plan of Michigan, Inc.

  • Health Maintenance Organization
  • Detroit, MI
  • NPI 1215581715
  NPD tax ID

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564963200000",
    "number": "1043865249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 HENDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341143",
            "telephone_number": "813-206-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 WOODWARD AVE STE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482263589",
            "telephone_number": "888-773-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN HEALTH PLAN OF MICHIGAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLCARE OF MICHIGAN HOLDING COMPANY",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VICE PRESIDENT, SECRETARY",
        "authorized_official_telephone_number": "813-206-3252"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NAIC",
            "identifier": "52653",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominique Dion Meredith, CNA
• Anne Merhar, MA, CCC-SLP
• Zachary Isaac Merhavy, MD
• Marlene Merideth
• Meridian Health Plan of Iowa, Inc.
• Meridian Health Plan of Michigan, Inc.
• Meridian Health Plan, Inc.
• Brad M Merker, PH. D.
• Cassidy Diane Merklen
• Alec Merlington, MD

• Health Maintenance Organization in Detroit, MI
• Providers in Detroit, MI by specialty
• Health Maintenance Organization in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.