Meridian Health Services Corp

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MERIDIAN HEALTH SERVICES CORP

Practice address

2506 Willowbrook Pkwy Ste 102a
Indianapolis, IN 46205-1542

Phone

(317) 803-2270

Fax

(317) 217-3029

NPI assigned

Feb 1, 2018

Organization subpart

No

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

Authorized official

Name

Gary Gates

Title

Revenue Cycle Manager

Phone

(765) 254-2685

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 151018

Legal name

MERIDIAN HEALTH SERVICES

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 12, 2018

Last certification

Feb 12, 2018

Ownership / control type

For profit – corporation

Facility address

2506 Willowbrook Pkwy Ste 102 a
Indianapolis, IN 46205

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

{
    "created_epoch": "1517443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517443200000",
    "number": "1346748654",
    "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": "2506 WILLOWBROOK PKWY STE 102A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051542",
            "telephone_number": "317-803-2270",
            "fax_number": "317-217-3029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-01",
        "last_updated": "2018-02-01",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "765-254-2685"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meridian Direct Primary Care
• Meridian Direct Primary Care LLC
• Meridian Foot and Ankle Center
• Meridian Gap Closure LLC
• Meridian Health & Wellness
• Meridian Health Services Corp.
• Meridian Health Services Corp.
• Meridian Hospice, LLC
• Meridian Laboratory Services LLC
• Meridian Laboratory Services LLC

• Federally Qualified Health Center (FQHC) in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Federally Qualified Health Center (FQHC) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.