Individual provider Active NPI

Mary Cathryn Merideth, ARNP

  • Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1114930229
Registry record updated Dec 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R0077161 Issued in OK
Practice address
2017 W I 35 Frontage Rd
Edmond, OK 73013-8504
Phone
(405) 509-2800
Fax
(405) 509-2885
NPI assigned
Aug 14, 2006
Last updated
Dec 1, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R0077161 OK Primary

Addresses

Primary practice location

2017 W I 35 Frontage Rd
Edmond, OK 73013-8504

Mailing address

530 N Monte Vista
Suite a
Ada, OK 74820-4675
Phone (580) 436-7101

Other identifiers 1

IdentifierTypeStateIssuer
200044620AMedicaidOK

Other names 1

  • Cathryn Sullivan Merideth Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0077161OKMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1114930229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 N MONTE VISTA",
            "address_2": "SUITE A",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748204675",
            "telephone_number": "580-436-7101",
            "fax_number": "580-436-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W I 35 FRONTAGE RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138504",
            "telephone_number": "405-509-2800",
            "fax_number": "405-509-2885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERIDETH",
        "first_name": "MARY",
        "middle_name": "CATHRYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "R0077161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200044620A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHRYN",
            "last_name": "MERIDETH",
            "middle_name": "SULLIVAN",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; 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.