Organization Active NPI

Meridian Internal Medicine and Primary Care Inc

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1366795973
Registry record updated Nov 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
044049 Issued in GA
Legal business name
MERIDIAN INTERNAL MEDICINE AND PRIMARY CARE INC
Practice address
3890 Redwine Rd SW Ste 210
Atlanta, GA 30331-5583
Phone
(404) 691-6688
NPI assigned
Oct 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2012

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

Authorized official

Name
Dr. Kay Olukayode Oso, MDNPI 1497898662
Title
MGR
Phone
(678) 485-5705

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 044049 GA Primary

Addresses

Primary practice location

3890 Redwine Rd SW Ste 210
Atlanta, GA 30331-5583

Mailing address

1029 N Peachtree Pkwy Ste 376
Peachtree City, GA 30269-4210
Phone (404) 691-6688

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121213000254 GA Part B Supplier - Clinic/Group Practice 3870745177 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2051262Meridian Internal Medicine & Primary Care Inc3890 Redwine Road, SW, Atlanta, GA 30331Certificate of waiverDec 16, 2026

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8606/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352851200000",
    "number": "1366795973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 N PEACHTREE PKWY STE 376",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302694210",
            "telephone_number": "404-691-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 REDWINE RD SW STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315583",
            "telephone_number": "404-691-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN INTERNAL MEDICINE AND PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-11-14",
        "status": "A",
        "authorized_official_last_name": "OSO",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "OLUKAYODE",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "678-485-5705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "044049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.