Active NPI
Jermaine Meades II
- Medical Laboratory Technician
- Philadelphia, PA
National Provider Identifier
1871281519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Laboratory Technician
- License
- 24804
- Practice address
- 3900 Woodland Ave
Philadelphia, PA 19104-4594 - Phone
- (302) 562-6266
- NPI assigned
- May 1, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Medical Laboratory Technician | 246RM2200X | 24804 | DE | Primary |
Addresses
Primary practice location
3900 Woodland Ave
Philadelphia, PA 19104-4594
Mailing address
109 Bernice Dr
Bear, DE 19701-2040
Phone (302) 562-6266
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24804 | DE | MD | Medical Laboratory Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1871281519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 BERNICE DR",
"city": "BEAR",
"state": "DE",
"postal_code": "197012040",
"telephone_number": "302-562-6266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3900 WOODLAND AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044594",
"telephone_number": "302-562-6266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEADES",
"first_name": "JERMAINE",
"name_prefix": "Mr.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-01",
"last_updated": "2023-05-01",
"certification_date": "2023-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "246RM2200X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Medical Laboratory",
"state": "DE",
"license": "24804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.