Children's Clinic of Meridian

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

17363 Issued in MS

Legal business name

CHILDREN'S CLINIC OF MERIDIAN

Practice address

1430 Hwy 19 N
Meridian, MS 39307-5378

Phone

(601) 282-5346

Fax

(601) 282-5347

NPI assigned

Feb 12, 2009

Last updated

Feb 12, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pedro A Munera-Cordoba, M.D.

Title

Clinical Director

Phone

(601) 282-5346

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1346489457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 HWY 19 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075378",
            "telephone_number": "601-282-5346",
            "fax_number": "601-282-5347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 HWY 19 N",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075378",
            "telephone_number": "601-282-5346",
            "fax_number": "601-282-5347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CLINIC OF MERIDIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "MUNERA-CORDOBA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "601-282-5346",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MS",
            "license": "17363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Meridian, MS
• Providers in Meridian, MS by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.