NPIMap

Organization Active NPI

Meridian Health Services Corp

  • Rural Health Clinic/Center
  • Rushville, IN
National Provider Identifier
1477504181
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MERIDIAN HEALTH SERVICES CORP
Practice address
509 Harcourt Way
Rushville, IN 46173-1165
Phone
(765) 932-3699
Fax
(765) 932-4164
NPI assigned
May 15, 2006
Last updated
Dec 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Mr. Kirk Shafer
Title
C.F.O.
Phone
(765) 288-1928

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X NU
Rural Health Clinic/Center 261QR1300X NU
Rural Health Clinic/Center 261QR1300X IN Primary

Addresses

Primary practice location

509 Harcourt Way
Rushville, IN 46173-1165

Mailing address

240 N. Tillotson Avenue
Muncie, IN 47304-3988
Phone (765) 288-1928

Other identifiers 2

IdentifierTypeStateIssuer
100216100MedicaidIN
100216100AMedicaidIN

Other names 1

  • Meridian Health Services Corp-Rushville Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031119000531 IN Part B Supplier - Clinic/Group Practice 5597679845 Receives reassigned benefits from 319 practitioners
48 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 48

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 48

National Provider Directory

National Provider Directory

Locations

509 Harcourt Way
Rushville, IN 46173
Phone (765) 932-3699

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1477504181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N. TILLOTSON AVENUE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 HARCOURT WAY",
            "city": "RUSHVILLE",
            "state": "IN",
            "postal_code": "461731165",
            "telephone_number": "765-932-3699",
            "fax_number": "765-932-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "765-288-1928",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216100",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100216100A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meridian Health Services Corp-Rushville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rushville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.