NPIMap

Organization Active NPI

Meridian Education Resource Group, Inc.

Doing business as Whitefoord, Inc.

  • Federally Qualified Health Center (FQHC)
  • Atlanta, GA
National Provider Identifier
1730305004
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MERIDIAN EDUCATION RESOURCE GROUP, INC.
Doing business as
Whitefoord, Inc.
Practice address
1401 Hosea Williams Dr SE
Atlanta, GA 30317-1703
Phone
(404) 373-6614
NPI assigned
Apr 17, 2007
Last updated
Feb 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Craig Tindall
Title
Ceo
Phone
(404) 373-6614

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X GA Primary

Addresses

Primary practice location

1401 Hosea Williams Dr SE
Atlanta, GA 30317-1703

Mailing address

1353 George W Brumley Way SE
Atlanta, GA 30317-1743
Phone (404) 523-2500

Other practice location 1

30 Warren St SE
Atlanta, GA 30317-2267
Phone (404) 373-6614

Other identifiers 2

IdentifierTypeStateIssuer
85000942GMedicaidGA
85002417GMedicaidGA

Other names 1

  • Whitefoord, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140502001158 GA Part B Supplier - Clinic/Group Practice 1456583723 Receives reassigned benefits from 10 practitioners
Practice locations: Atlanta, GA
O20150413001801 GA Part A Provider - Federally Qualified Health Center (FQHC) 1456583723 Practice locations: Atlanta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730305004. Details of each certification follow.

Federally qualified health center certification: CCN 111006

Legal name
MERIDIAN EDUCATION RESOURCE GROUP, INC.
Doing business as
WHITEFOORD, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 13, 2015
Last certification
Apr 13, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 17, 1994 in GA
Enrollment address
1401 Hosea Williams Dr NE
Atlanta, GA 30317-1703

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Meridian Education Resource Group Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

2220 Campbellton Rd SW
Atlanta, GA 30311
Phone (404) 373-6614

35 Rogers St NE
Atlanta, GA 30317

35 Whitefoord Ave SE
Atlanta, GA 30317
Phone (404) 588-0101

433 Peeples St SW
Atlanta, GA 30310
Phone (404) 373-6614

545 Hill St SE
Atlanta, GA 30312
Phone (404) 373-6614

555 Luckie St NW
Atlanta, GA 30313

569 Martin Luther King Jr Dr NW
Atlanta, GA 30314

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Meridian Education Resource Group, Inc. Organization, Atlanta, GA Non-profit Operational/Managerial Control Nov 17, 1994 100%
Craig Tindall Individual Corporate OfficerCeo Oct 1, 2020 100%
W-2 Managing EmployeeCeo Oct 1, 2020 100%
Operational/Managerial ControlCeo Oct 1, 2020 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Meridian Education Resource Group, Inc.Atlanta, GA, CCN 851160 Federally qualified health center Operational/Managerial Control (100%) Nov 17, 1994

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 12

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1730305004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 GEORGE W BRUMLEY WAY SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303171743",
            "telephone_number": "404-523-2500",
            "fax_number": "404-522-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HOSEA WILLIAMS DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303171703",
            "telephone_number": "404-373-6614"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Warren St SE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303172267",
            "country_code": "US",
            "telephone_number": "404-373-6614",
            "fax_number": "404-588-0226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERIDIAN EDUCATION RESOURCE GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "TINDALL",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-373-6614"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85000942G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85002417G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Whitefoord, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Whitefoord, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.