NPIMap

Organization Active NPI

Meridian Health Services Corp

  • Federally Qualified Health Center (FQHC)
  • Muncie, IN
National Provider Identifier
1336597301
Registry record updated May 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MERIDIAN HEALTH SERVICES CORP
Practice address
110 E Wysor St
Muncie, IN 47305-1724
Phone
(765) 288-1928
Fax
(765) 741-0335
NPI assigned
May 31, 2016
Last updated
May 31, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2016

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

Authorized official

Name
Kirk Shafer
Title
Cfo
Phone
(765) 288-1928

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

110 E Wysor St
Muncie, IN 47305-1724

Mailing address

240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000531 IN Part B Supplier - Clinic/Group Practice 5597679845 Receives reassigned benefits from 319 practitioners
48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 48

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

View all 48

National Provider Directory

National Provider Directory

Locations

1026 S Main St
Ste 1
Bluffton, IN 46714
Phone (260) 888-2102

Practitioners & affiliated clinicians

Practitioners 2

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": "1464652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464652800000",
    "number": "1336597301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E WYSOR ST",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473051724",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-31",
        "last_updated": "2016-05-31",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "765-288-1928"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; 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.