Organization Active NPI

Meridian Internal Medicine, P.a.

  • Internal Medicine Physician
  • Asheboro, NC
National Provider Identifier
1912234683
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2000-01522 Issued in NC
Legal business name
MERIDIAN INTERNAL MEDICINE, P.A.
Practice address
306 N Cox St
Asheboro, NC 27203-5528
Phone
(336) 633-3073
Fax
(336) 633-3074
NPI assigned
Nov 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Caroline C Prochnau, M.D.NPI 1942287354
Title
President/Owner
Phone
(336) 633-3073

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 2000-01522 NC Primary

Addresses

Primary practice location

306 N Cox St
Asheboro, NC 27203-5528

Mailing address

PO Box 4937
Asheboro, NC 27204-4937
Phone (336) 633-3073

Other identifiers 1

IdentifierTypeStateIssuer
5913593MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100331000334 NC Part B Supplier - Clinic/Group Practice 8921134784 Receives reassigned benefits from 1 practitioner
Practice locations: Asheboro, NC

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2003230Meridian Internal Medicine PA306 North Cox Street, Asheboro, NC 27203Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory

Locations

306 N Cox St
Asheboro, NC 27203
Phone (336) 633-3073

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1912234683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4937",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272044937",
            "telephone_number": "336-633-3073",
            "fax_number": "336-633-3074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 N COX ST",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272035528",
            "telephone_number": "336-633-3073",
            "fax_number": "336-633-3074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN INTERNAL MEDICINE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-17",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "PROCHNAU",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "336-633-3073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2000-01522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5913593",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.