Individual provider Active NPI

Terry Meriden, MD FACP FACN FACE

  • Endocrinology, Diabetes & Metabolism Physician
  • Peoria, IL
National Provider Identifier
1467538231
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
0360586021 Issued in IL
Practice address
900 Main Street
Suite 300
Peoria, IL 61602
Phone
(309) 673-1717
Fax
(309) 673-7221
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 0360586021 IL Primary

Addresses

Primary practice location

900 Main Street
Suite 300
Peoria, IL 61602

Mailing address

900 Main Street
Suite 300
Peoria, IL 61602
Phone (309) 673-1717

Other identifiers 3

IdentifierTypeStateIssuer
036058602MedicaidIL
792111124OtherRAILROAD MEDICARE
9000138OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0360586021ILMDEndocrinology, Diabetes & Metabolism Physician

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363132800000",
    "number": "1467538231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN STREET",
            "address_2": "SUITE 300",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61602",
            "telephone_number": "309-673-1717",
            "fax_number": "309-673-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN STREET",
            "address_2": "SUITE 300",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61602",
            "telephone_number": "309-673-1717",
            "fax_number": "309-673-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERIDEN",
        "first_name": "TERRY",
        "name_prefix": "Mr.",
        "credential": "MD FACP FACN FACE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2013-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "IL",
            "license": "0360586021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058602",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "792111124",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "9000138",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.