NPIMap

Organization Active NPI

Meridia Medical Group LLC

  • Family Medicine Physician
  • Mentor, OH
National Provider Identifier
1497948111
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
34001608T Issued in OH
Legal business name
MERIDIA MEDICAL GROUP LLC
Practice address
8316 Yellowbrick Rd
Mentor, OH 44060-4960
Phone
(440) 205-8818
Fax
(440) 974-1794
NPI assigned
Aug 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Michael O'Connell
Title
V.P of Operations
Phone
(216) 761-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 34001608T OH Primary

Addresses

Primary practice location

8316 Yellowbrick Rd
Mentor, OH 44060-4960

Mailing address

275 Springside Dr
Suite 100
Akron, OH 44333-4548
Phone (234) 466-4083

Other identifiers 1

IdentifierTypeStateIssuer
2716118MedicaidOH

National Provider Directory

National Provider Directory
Tax ID family
Meridia Medical Group LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8316 Yellowbrick Rd
Mentor, OH 44060
Phone (216) 342-2190

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1497948111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SPRINGSIDE DR",
            "address_2": "SUITE 100",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443334548",
            "telephone_number": "234-466-4083",
            "fax_number": "866-211-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8316 YELLOWBRICK RD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604960",
            "telephone_number": "440-205-8818",
            "fax_number": "440-974-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "V.P OF OPERATIONS",
        "authorized_official_telephone_number": "216-761-3300"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34001608T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2716118",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.