NPIMap

Organization Active NPI

Meridia Medical Group LLC

  • Family Medicine Physician
  • Euclid, OH
National Provider Identifier
1508058314
Registry record updated Nov 16, 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
26151 Euclid Ave
Suite 201
Euclid, OH 44132-3300
Phone
(216) 261-7970
Fax
(216) 261-6191
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 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

26151 Euclid Ave
Suite 201
Euclid, OH 44132-3300

Mailing address

275 Springside Dr
Akron, OH 44333-4548

Other identifiers 1

IdentifierTypeStateIssuer
2691118MedicaidOH

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.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195171200000",
    "number": "1508058314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SPRINGSIDE DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443334548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26151 EUCLID AVE",
            "address_2": "SUITE 201",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441323300",
            "telephone_number": "216-261-7970",
            "fax_number": "216-261-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIA MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-11-16",
        "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": "2691118",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.