Active NPI
Joseph1940 Harry Merickel, M.D.
- Specialist
- Alexandria, MN
National Provider Identifier
1831390830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 17363
- Practice address
- 1109 Maple St
Alexandria, MN 56308-2626 - Phone
- (320) 763-4906
- NPI assigned
- May 29, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 17363 | MN | Primary |
Addresses
Primary practice location
1109 Maple St
Alexandria, MN 56308-2626
Mailing address
1109 Maple St
Alexandria, MN 56308-2626
Phone (320) 763-4906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17363 | Other | MN | LICENSE TO PRACTICE MEDIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17363 | MN | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831390830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1109 MAPLE ST",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082626",
"telephone_number": "320-763-4906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1109 MAPLE ST",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082626",
"telephone_number": "320-763-4906"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERICKEL",
"first_name": "JOSEPH1940",
"middle_name": "HARRY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MN",
"license": "17363",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE TO PRACTICE MEDIC",
"identifier": "17363",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.