Meridian Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

MERIDIAN DERMATOLOGY PLLC

Practice address

3250 N Leslie Way Ste 110
Meridian, ID 83646-5362

Phone

(208) 609-9500

NPI assigned

Oct 6, 2021

Organization subpart

No

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

Authorized official

Name

Ryan Jeffrey Harris, MDNPI 1952628745

Title

Owner, Physician

Phone

(434) 987-3922

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00202

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan J Harris, MD

  • Dermatology Physician
  • Meridian, ID
  • NPI 1952628745
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1780346809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 S BONITO WAY STE 190",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836425618",
            "telephone_number": "208-287-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 N LESLIE WAY STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836465362",
            "telephone_number": "208-609-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER, PHYSICIAN",
        "authorized_official_telephone_number": "434-987-3922",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Chandler Merchant, DC
• Meridian Adult Medicine, PLLC
• Meridian Chiropractic Clinic LLC
• Meridian Counseling Center
• Meridian Dental, PLLC
• Meridian Developmental Center, Inc.
• Meridian Developmental Services LLC
• Meridian Healthcare LLC
• Meridian Healthcare LLC
• Meridian Hearing AIDS LLC

• Dermatology Physician in Meridian, ID
• Providers in Meridian, ID by specialty
• Dermatology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.