NPIMap

Organization Active NPI

Meridian Health Services Corp

  • Substance Abuse Rehabilitation Facility
  • Richmond, IN
National Provider Identifier
1508300161
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
MERIDIAN HEALTH SERVICES CORP
Practice address
498 NW 18TH St
Suite a
Richmond, IN 47374-2851
Phone
(765) 288-1928
Fax
(765) 741-0335
NPI assigned
Dec 15, 2016
Last updated
Dec 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

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

Authorized official

Name
Kirk Shafer
Title
Cfo, VP
Phone
(765) 288-1928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

498 NW 18TH St
Suite a
Richmond, IN 47374-2851

Mailing address

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

Other names 1

  • Residential Substance Abuse Treatment Program 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
Tax ID family
Comprehensive Mental Health58 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

498 NW 18th St
Ste A
Richmond, IN 47374

NPI Registry JSON

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

{
    "created_epoch": "1481760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481760000000",
    "number": "1508300161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "498 NW 18TH ST",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473742851",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-15",
        "last_updated": "2016-12-15",
        "status": "A",
        "authorized_official_last_name": "SHAFER",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "CFO, VP",
        "authorized_official_telephone_number": "765-288-1928"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Residential Substance Abuse Treatment Program",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; 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.