Organization Active NPI

Dr. Kevin McElroy, OD PA

Doing business as Meridian Vision

  • Optometrist
  • Meridian, ID
National Provider Identifier
1215054291
Registry record updated Jan 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
O-653 Issued in ID
Legal business name
DR. KEVIN MCELROY, OD PA
Doing business as
Meridian Vision
Practice address
50 E Carmel Dr
Meridian, ID 83646-3301
Phone
(208) 888-5252
Fax
(208) 884-4280
NPI assigned
Mar 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2014

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

Authorized official

Name
Dr. Kevin W McElroy, O.D. P.A.
Title
President
Phone
(208) 888-5252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X O-653 ID Primary

Addresses

Primary practice location

50 E Carmel Dr
Meridian, ID 83646-3301

Mailing address

50 E Carmel Dr
Meridian, ID 83646-3301
Phone (208) 888-5252

Other identifiers 2

IdentifierTypeStateIssuer
V7169OtherIDBLUE CROSS OF IDAHO
003410000MedicaidID

Other names 1

  • Meridian Vision Doing business as

National Provider Directory

National Provider Directory

Locations

1012 N Main St
Meridian, ID 83642
Phone (208) 888-5252

50 E Carmel Dr
Meridian, ID 83646
Phone (208) 888-5252

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388534400000",
    "number": "1215054291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E CARMEL DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836463301",
            "telephone_number": "208-888-5252",
            "fax_number": "208-884-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E CARMEL DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836463301",
            "telephone_number": "208-888-5252",
            "fax_number": "208-884-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. KEVIN MCELROY, OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2014-01-01",
        "status": "A",
        "authorized_official_last_name": "MCELROY",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-888-5252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D. P.A."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "O-653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "V7169",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003410000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

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