Individual provider Active NPI

Jessica Ann Merideth, MSN, FNP-C

  • Family Nurse Practitioner
  • Taylor, MI
National Provider Identifier
1164211397
Registry record updated Sep 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704327710 Issued in MI
Practice address
24887 Goddard Rd
Taylor, MI 48180-3930
Phone
(734) 946-7200
NPI assigned
May 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F03250739 MI
Family Nurse Practitioner 363LF0000X 4704327710 MI Primary

Addresses

Primary practice location

24887 Goddard Rd
Taylor, MI 48180-3930

Mailing address

29071 Sugar Island CT
Gibraltar, MI 48173-9571
Phone (313) 720-7862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107001663 MI Order and Referring Only - Nurse Practitioner 1355831322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
4704327710MIMDFamily Nurse Practitioner
F03250739MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
M a Haroon, MD, PC CurrentSince Sep 8, 2025 Accepting new patients
Omega Home Medical Equipment, Inc PastSince Sep 8, 2025 Accepting new patients

Locations

24887 Goddard Rd
Taylor, MI 48180
Phone (734) 946-0228

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756684800000",
    "number": "1164211397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29071 SUGAR ISLAND CT",
            "city": "GIBRALTAR",
            "state": "MI",
            "postal_code": "481739571",
            "telephone_number": "313-720-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24887 GODDARD RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803930",
            "telephone_number": "734-946-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERIDETH",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-05",
        "last_updated": "2025-09-01",
        "certification_date": "2025-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F03250739",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704327710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

Verify at the official NPI Registry.