NPIMap

Organization Active NPI

Meridian Primary Care PC

  • Family Medicine Physician
  • Okemos, MI
National Provider Identifier
1629128418
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DP052522 Issued in MI
Legal business name
MERIDIAN PRIMARY CARE PC
Practice address
2270 Jolly Oak Rd
Suite1
Okemos, MI 48864-4528
Phone
(517) 349-6140
Fax
(517) 349-6216
NPI assigned
Jan 12, 2007
Last updated
Jun 5, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Authorized official

Name
Dr. Dennis J Perry, M.D.NPI 1770578965
Title
Owner
Phone
(517) 349-6140

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X KC064356 MI
Family Medicine Physician 207Q00000X DP052522 MI Primary

Addresses

Primary practice location

2270 Jolly Oak Rd
Suite1
Okemos, MI 48864-4528

Mailing address

2270 Jolly Oak Rd
Suite 1
Okemos, MI 48864-4528
Phone (517) 349-6140

Other identifiers 2

IdentifierTypeStateIssuer
4187015MedicaidMI
4186985MedicaidMI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401926400000",
    "number": "1629128418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2270 JOLLY OAK RD",
            "address_2": "SUITE 1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644528",
            "telephone_number": "517-349-6140",
            "fax_number": "517-349-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2270 JOLLY OAK RD",
            "address_2": "SUITE1",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488644528",
            "telephone_number": "517-349-6140",
            "fax_number": "517-349-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2014-06-05",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-349-6140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "KC064356",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "DP052522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4187015",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4186985",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; 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.