Individual provider Active NPI

Meredith A Myers, PNP

  • Pediatric Nurse Practitioner
  • Kennebunk, ME
National Provider Identifier
1316080146
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CNP81663 Issued in ME
Practice address
3 Shape Dr
Kennebunk, ME 04043-6601
Phone
(207) 467-8930
Fax
(207) 985-8459
NPI assigned
Feb 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X CNP81663 ME Primary
Nurse Practitioner 363L00000X CNP81663 ME
Pediatric Nurse Practitioner 363LP0200X R041189 ME

Addresses

Primary practice location

3 Shape Dr
Kennebunk, ME 04043-6601

Mailing address

1 Medical Center Dr
PO Box 626
Biddeford, ME 04005-9422
Phone (207) 282-9080

Other identifiers 2

IdentifierTypeStateIssuer
30346785MedicaidNH
432994999MedicaidME

Other names 1

  • Meredith A Norris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20080922000119 ME Practitioner - Nurse Practitioner 5496822231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
97.93 of 100Reported as apm
Quality
83.31
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CNP81663MEMDPediatric Nurse Practitioner
R041189MEMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Oct 1, 2013 Accepting new patients
Mainehealth CurrentSince Dec 1, 2018 Accepting new patients
Mainehealth CurrentSince Oct 1, 2013 Accepting new patients
Mainehealth CurrentSince Dec 1, 2018 Accepting new patients
Mainehealth Current Accepting new patients

Locations

1 Medical Dr
Biddeford, ME 04005
Phone (207) 283-7000

3 Shape Dr
Kennebunk, ME 04043
Phone (207) 467-8930

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

Organizations & group practices 5

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": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1316080146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "PO BOX 626",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059422",
            "telephone_number": "207-282-9080",
            "fax_number": "207-985-8459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHAPE DR",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436601",
            "telephone_number": "207-467-8930",
            "fax_number": "207-985-8459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "MEREDITH",
        "middle_name": "A",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-14",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "CNP81663",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ME",
            "license": "CNP81663",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "R041189",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30346785",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432994999",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "NORRIS",
            "middle_name": "A",
            "credential": "PNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennebunk, ME

Sources for this page

Verify at the official NPI Registry.