Individual provider Active NPI

Elizabeth Meacham, NP

  • Nurse Practitioner
  • Muskegon, MI
National Provider Identifier
1912911108
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704178823 Issued in MI
Practice address
1675 Leahy St
Suite 428B
Muskegon, MI 49442-5500
Phone
(231) 672-3300
Fax
(231) 672-3380
NPI assigned
Jul 27, 2006
Last updated
Aug 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704178823 MI Primary
Family Medicine Physician 207Q00000X 4704178823 MI

Addresses

Primary practice location

1675 Leahy St
Suite 428B
Muskegon, MI 49442-5500

Mailing address

PO Box 1847
Muskegon, MI 49443-1847
Phone (231) 727-4444

Other identifiers 1

IdentifierTypeStateIssuer
4612399MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040707000022 MI Practitioner - Nurse Practitioner 5193702256 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Women's Health ServicesGroup PAC ID 9133171358, 11 clinicians

Practice addresses (Care Compare)

1675 Leahy St
Suite 201a
Muskegon, MI 49442-5542
Phone (231) 672-6600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704178823MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Partners-Obstetrics and Gynecology Specialist Nurse Practitioner CurrentSince Apr 20, 2012 Accepting new patients
Mercy Women's Health Services Nurse Practitioner CurrentSince Feb 10, 2013 Accepting new patients
Appleview Women's Health Care, P.C. Past Accepting new patients
Patricia Roy D.O. PC Family Medicine PastSince Jan 18, 1990 Accepting new patients

Locations

1675 Leahy St
Ste 201A
Muskegon, MI 49442
Phone (231) 672-6600

1675 Leahy St
Ste 428B
Muskegon, MI 49442
Phone (231) 672-3300

1775 Wells Ave
Muskegon, MI 49442
Phone (231) 726-2677

1778 Sanford St
Muskegon, MI 49441
Phone (231) 672-2160

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344556800000",
    "number": "1912911108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-727-4444",
            "fax_number": "231-727-4451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST",
            "address_2": "SUITE 428B",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425500",
            "telephone_number": "231-672-3300",
            "fax_number": "231-672-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEACHAM",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704178823",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4704178823",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4612399",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.