Organization Active NPI

Meridian Living, LLC

  • Assisted Living Facility
  • Meridian, MS
National Provider Identifier
1104574300
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
MERIDIAN LIVING, LLC
Practice address
538 Bonita Lakes Dr
Meridian, MS 39301-6992
Phone
(601) 512-0512
Fax
(601) 693-3350
NPI assigned
Mar 16, 2022
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Robert Anderson
Title
Cfo
Phone
(601) 918-7733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

538 Bonita Lakes Dr
Meridian, MS 39301-6992

Mailing address

538 Bonita Lakes Dr
Meridian, MS 39301-6992
Phone (601) 512-0512

Other identifiers 1

IdentifierTypeStateIssuer
1242OtherMSDEPARTMENT OF HEALTH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL candace@themeridianliving.com Direct

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
25D2194078Meridian Living538 Bonita Lakes Dr, Meridian, MS 39301Certificate of waiverSep 27, 2026

National Provider Directory

National Provider Directory

Locations

538 Bonita Lakes Dr
Meridian, MS 39301
Phone (601) 512-0512

NPI Registry JSON

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

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1104574300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 BONITA LAKES DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393016992",
            "telephone_number": "601-512-0512",
            "fax_number": "601-693-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 BONITA LAKES DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393016992",
            "telephone_number": "601-512-0512",
            "fax_number": "601-693-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-918-7733"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "1242",
            "state": "MS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "candace@themeridianliving.com",
            "affiliation": "N",
            "endpointDescription": "Executive Director",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "538 Bonita Lakes Dr",
            "city": "Meridian",
            "state": "MS",
            "country_code": "US",
            "postal_code": "393016992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.