Meridian Therapeutics Clinic LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MERIDIAN THERAPEUTICS CLINIC LLC

Practice address

4045 E Bell Rd
Ste 111
Phoenix, AZ 85032-2236

Phone

(602) 606-2658

Fax

(602) 428-7003

NPI assigned

Mar 8, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Kimara Vaughn, NP

Title

Owner/ Nurse Practitioner

Phone

(602) 606-2658

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1457395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457395200000",
    "number": "1689035479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD",
            "address_2": "STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322236",
            "telephone_number": "602-606-2658",
            "fax_number": "602-428-7003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045 E BELL RD",
            "address_2": "STE 111",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850322236",
            "telephone_number": "602-606-2658",
            "fax_number": "602-428-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN THERAPEUTICS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-08",
        "last_updated": "2016-03-08",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "KIMARA",
        "authorized_official_title_or_position": "OWNER/ NURSE PRACTITIONER",
        "authorized_official_telephone_number": "602-606-2658",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNKNOWN",
            "identifier": "000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Sue Mericle, FNP
• Jasmin Graciela Merida, OT
• Christina Michelle Meridew, PHARMD
• Meridian Health Care Providers, Inc
• Meridian Home Care LLC Az
• Nawal Merjaneh
• Kristin L. Merkel, SCHOOL COUNSELOR
• Mary E. Merkel, M.D.
• Tricia Merkley, PHD
• Jaron Daniel Merlina

• Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; 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.