Individual provider Active NPI

Meredith A Crider, APRN

  • Primary Care Nurse Practitioner
  • Benton, KY
National Provider Identifier
1447713623
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
3013300 Issued in KY
Practice address
615 Old Symsonia Rd
Benton, KY 42025-5042
Phone
(270) 527-4800
Fax
(270) 527-4910
NPI assigned
Apr 13, 2019
Last updated
Jul 7, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 3013300 KY Primary

Addresses

Primary practice location

615 Old Symsonia Rd
Benton, KY 42025-5042

Mailing address

PO Box 9150
Paducah, KY 42002-9150
Phone (270) 744-9600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mereditha2016@outlook.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20190605001907 KY Practitioner - Nurse Practitioner 8527391671 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Partners, PLLCGroup PAC ID 6204018617, 4 clinicians

Practice addresses (Care Compare)

615 Old Symsonia Rd
Benton, KY 42025-5042
Phone (270) 527-4800

617 Old Symsonia Rd
Benton, KY 42025-5042
Phone (270) 527-2411

619 Old Symsonia Rd
Benton, KY 42025-5042

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3013300KYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Medical Staffing PLLC CurrentSince Jan 1, 2020 Accepting new patients
Marshall County Hospital District CurrentSince Oct 31, 2020 Accepting new patients
MD Partners, PLLC CurrentSince Feb 26, 2020 Accepting new patients
Marshall County Hospital District CurrentSince Oct 31, 2020 Accepting new patients
Marshall County Hospital District Past Accepting new patients
Baptist Health Medical Group Inc Past Accepting new patients

Locations

615 Old Symsonia Rd
Benton, KY 42025
Phone (270) 527-4800

617 Old Symsonia Rd
Benton, KY 42025
Phone (270) 527-2411

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

2501 Kentucky Ave
Fl 5
Paducah, KY 42003
Phone (270) 415-7794

2501 Kentucky Ave
Ste 101
Paducah, KY 42003
Phone (270) 442-8575

4620 Village Square Dr
Paducah, KY 42001
Phone (270) 442-8575

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/marshal-fc975078
  • Direct secure messaging: mcrider666036@direct.bsmhealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1447713623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9150",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420029150",
            "telephone_number": "270-744-9600",
            "fax_number": "270-744-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 OLD SYMSONIA RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420255042",
            "telephone_number": "270-527-4800",
            "fax_number": "270-527-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIDER",
        "first_name": "MEREDITH",
        "middle_name": "A",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-13",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3013300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mereditha2016@outlook.com",
            "affiliation": "N",
            "endpointDescription": "direct email",
            "address_1": "4620 Village Square Dr",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420017501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Benton, KY

Sources for this page

Verify at the official NPI Registry.