Meadowcrest Healthcare Services LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

MEADOWCREST HEALTHCARE SERVICES LLC

Practice address

512 N Lecanto Hwy
Lecanto, FL 34461-8547

Phone

(352) 795-0644

NPI assigned

Feb 21, 2024

Organization subpart

Yes

Parent organization

MEADOWCREST FAMILY PHYSICIANS, P.A.As reported in NPPES

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

Authorized official

Name

Dr. Ryan Dickert, MDNPI 1306231212

Title

Owner

Phone

(352) 795-0644

Specialties & licenses 1

Addresses

Part of

Meadowcrest Family Physicians PA

Locations

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.

• Ryan Spencer Dickert, MD

  • Family Medicine Physician
  • Crystal River, FL
  • NPI 1306231212
  Authorized official Same address or phone

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

{
    "created_epoch": "1708473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1669238325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 N VANTAGE POINT DR",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344295736",
            "telephone_number": "352-795-0644",
            "fax_number": "352-795-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N LECANTO HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344618547",
            "telephone_number": "352-795-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWCREST HEALTHCARE SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEADOWCREST FAMILY PHYSICIANS, P.A.",
        "enumeration_date": "2024-02-21",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "DICKERT",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-795-0644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ralph Eugene Massullo Jr., MD
• Marcia June McGee, ARNP
• Andrew Spencer McGreevy, APRN, FNP-BC
• Tiffany McNeill, PTA
• Meadowcrest Family Physicians, P.a.
• Meadowcrest Healthcare Services LLC
• Medical Risk Solutions (MHO-Citrus County EHC-Lecanto)
• Vanessa Lynn Mellott, PHARM. D.
• Koanaki Mercado, RN
• Graciany Miranda Grajales, M.D.

• Rural Health Clinic/Center in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.