Individual provider Active NPI

Robert W Meikle, M.D.

  • Family Medicine Physician
  • Athens, PA
National Provider Identifier
1306986021
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD034073E Issued in PA
Practice address
412 S Main St
Athens, PA 18810-1618
Phone
(570) 888-9655
Fax
(570) 888-3842
NPI assigned
Feb 8, 2007
Last updated
Jun 25, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 038595 CT
Family Medicine Physician 207Q00000X MD034073E PA Primary

Addresses

Primary practice location

412 S Main St
Athens, PA 18810-1618

Mailing address

1 Guthrie SQ
Sayre, PA 18840-1625
Phone (570) 888-5858

Other identifiers 2

IdentifierTypeStateIssuer
1306986021MedicaidCT
D400011102OtherCTMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120713000112 PA Practitioner - Family Practice 5799824546 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
038595CTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Guthrie Medical Group, P.C. Family Medicine CurrentSince May 29, 2012 Accepting new patients
Guthrie Medical Group, P.C. Family Medicine CurrentSince May 29, 2012 Accepting new patients
L&M Physician Association, Inc Family Medicine Past Accepting new patients
Conncare Inc Family Medicine Past Accepting new patients

Locations

412 S Main St
Athens, PA 18810
Phone (570) 888-9655

1 Guthrie Sq
Sayre, PA 18840
Phone (570) 887-3106

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1306986021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUTHRIE SQ",
            "city": "SAYRE",
            "state": "PA",
            "postal_code": "188401625",
            "telephone_number": "570-888-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S MAIN ST",
            "city": "ATHENS",
            "state": "PA",
            "postal_code": "188101618",
            "telephone_number": "570-888-9655",
            "fax_number": "570-888-3842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEIKLE",
        "first_name": "ROBERT",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "038595",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD034073E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306986021",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "D400011102",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, PA

Sources for this page

Verify at the official NPI Registry.