Kevin Sam Merigian, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

21904 Issued in TN

Practice address

2849 Collierville Arlington N
Eads, TN 38028-9320

Phone

(901) 867-1018

Fax

(901) 867-1065

NPI assigned

Feb 6, 2007

Last updated

Jul 2, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1083753636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 205",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380280205",
            "telephone_number": "901-867-1018",
            "fax_number": "901-867-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2849 COLLIERVILLE ARLINGTON N",
            "city": "EADS",
            "state": "TN",
            "postal_code": "380289320",
            "telephone_number": "901-867-1018",
            "fax_number": "901-867-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERIGIAN",
        "first_name": "KEVIN",
        "middle_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Pharmacology",
            "state": "TN",
            "license": "21904",
            "primary": false
        },
        {
            "code": "209800000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "TN",
            "license": "21904",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "21904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Eads, TN
• Providers in Eads, TN by specialty
• General Practice Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.