NPIMap

Organization Active NPI

Quad Intermed Company LLC

Doing business as MEA Medical Clinic

  • Clinic/Center
  • Clinton, MS
National Provider Identifier
1154104339
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
QUAD INTERMED COMPANY LLC
Doing business as
MEA Medical Clinic
Practice address
498 Highway 80 E
Clinton, MS 39056-4720
Phone
(601) 924-4000
NPI assigned
Aug 14, 2023
Last updated
Aug 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Authorized official

Name
William M Grantham, MDNPI 1225048291
Title
Ceo
Phone
(601) 898-7530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

498 Highway 80 E
Clinton, MS 39056-4720

Mailing address

308 Corporate Dr
Ridgeland, MS 39157-8803
Phone (601) 898-7530

Other names 1

  • MEA Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230706000437 MS Part B Supplier - Clinic/Group Practice 6709245954 Receives reassigned benefits from 50 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pearl, MS; Brandon, MS; Yazoo City, MS; Vicksburg, MS; Ridgeland, MS; Richland, MS; Madison, MS; Laurel, MS…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Mea Medical Clinic14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

308 Corporate Dr
Ridgeland, MS 39157
Phone (601) 898-7500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1154104339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CORPORATE DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391578803",
            "telephone_number": "601-898-7530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 HIGHWAY 80 E",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564720",
            "telephone_number": "601-924-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD INTERMED COMPANY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-898-7530",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEA Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.