NPIMap

Organization Active NPI

Meridian Primary Care Clinic

  • Primary Care Clinic/Center
  • Lake City, FL
National Provider Identifier
1689165052
Registry record updated Jun 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
HCC Issued in FL
Legal business name
MERIDIAN PRIMARY CARE CLINIC
Practice address
439 SW Michigan St
Lake City, FL 32025
Phone
(352) 374-5600
NPI assigned
May 22, 2018
Organization subpart
Yes
Parent organization
MERIDIAN BEHAVIORAL HEALTHCARE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2018

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

Authorized official

Name
Lauren Cohn
Title
SVP Qi / Cpo
Phone
(352) 374-5600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X HCC FL
Primary Care Clinic/Center 261QP2300X HCC FL Primary

Addresses

Primary practice location

439 SW Michigan St
Lake City, FL 32025

Mailing address

4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

Other identifiers 1

IdentifierTypeStateIssuer
016511900MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Meridian Behavorial HLT29 organizations share this tax ID, including this one
Part of
Meridian Behavorial HLT

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1689165052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600",
            "fax_number": "352-244-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 SW MICHIGAN ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN PRIMARY CARE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERIDIAN BEHAVIORAL HEALTHCARE INC.",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "COHN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "SVP QI / CPO",
        "authorized_official_telephone_number": "352-374-5600"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "HCC",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "HCC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016511900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.