NPIMap

Organization Active NPI

Meridian Behavioral Healthcare, Inc.

  • Community/Behavioral Health Agency
  • Live Oak, FL
National Provider Identifier
1225205644
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MERIDIAN BEHAVIORAL HEALTHCARE, INC.
Practice address
920 NW Nobles Ferry Road
Live Oak, FL 32060
Phone
(386) 362-4218
Fax
(386) 364-5606
NPI assigned
May 14, 2008
Last updated
Oct 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Lauren Cohn
Title
SVP / Chief Performance Officer
Phone
(352) 374-5600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

920 NW Nobles Ferry Road
Live Oak, FL 32060

Mailing address

1565 SW Williston Rd
Gainesville, FL 32608-4044
Phone (352) 374-5600

Other identifiers 1

IdentifierTypeStateIssuer
362344011MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060502000237 FL Part B Supplier - Clinic/Group Practice 7517977812 Receives reassigned benefits from 99 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Cross City, FL; Trenton, FL; Starke, FL; Palatka, FL; Ocala, FL; Macclenny, FL; Live Oak, FL; Lake City, FL…

Other NPIs on the same Medicare enrollment 10

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

National Provider Directory

National Provider Directory
Tax ID family
Meridian Behavorial Hea29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Practitioners & affiliated clinicians

Practitioners 4

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": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1225205644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 SW WILLISTON RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084044",
            "telephone_number": "352-374-5600",
            "fax_number": "352-244-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 NW NOBLES FERRY ROAD",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "32060",
            "telephone_number": "386-362-4218",
            "fax_number": "386-364-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN BEHAVIORAL HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "COHN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "SVP / CHIEF PERFORMANCE OFFICER",
        "authorized_official_telephone_number": "352-374-5600"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362344011",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; 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.