Organization Active NPI

Meridian Health Plan of Michigan, Inc.

  • Health Maintenance Organization
  • Detroit, MI
National Provider Identifier
1215581715
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
MERIDIAN HEALTH PLAN OF MICHIGAN, INC.
Practice address
1 Campus Martius Ste 700
Detroit, MI 48226-5012
Phone
(888) 773-2647
NPI assigned
Aug 1, 2019
Organization subpart
Yes
Parent organization
WELLCARE OF MERIDIAN HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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

Authorized official

Name
Michael W Haber
Title
Vice President, Secretary
Phone
(813) 206-3252

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X Primary

Addresses

Primary practice location

1 Campus Martius Ste 700
Detroit, MI 48226-5012

Mailing address

8735 Henderson Rd
Tampa, FL 33634-1143
Phone (813) 206-3252

National Provider Directory

National Provider Directory
Tax ID family
Meridian Health Plan of Michigan2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1 Campus Martius
Ste 700
Detroit, MI 48226
Phone (734) 945-0482

NPI Registry JSON

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

{
    "created_epoch": "1564617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564617600000",
    "number": "1215581715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 HENDERSON RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341143",
            "telephone_number": "813-206-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CAMPUS MARTIUS STE 700",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482265012",
            "telephone_number": "888-773-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN HEALTH PLAN OF MICHIGAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLCARE OF MERIDIAN HOLDING COMPANY",
        "enumeration_date": "2019-08-01",
        "last_updated": "2019-08-01",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VICE PRESIDENT, SECRETARY",
        "authorized_official_telephone_number": "813-206-3252"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2019; 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.