NPIMap

Organization Active NPI

Philip W. Meyer MD PC

  • Pediatrics Physician
  • Council Bluffs, IA
National Provider Identifier
1922185487
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
20597 Issued in IA
Legal business name
PHILIP W. MEYER MD PC
Practice address
201 Ridge St
Suite 314
Council Bluffs, IA 51503-4643
Phone
(712) 322-0253
Fax
(712) 322-5273
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Philip W Meyer, MDNPI 1174519680
Title
President
Phone
(712) 322-0253

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 20597 IA Primary

Addresses

Primary practice location

201 Ridge St
Suite 314
Council Bluffs, IA 51503-4643

Mailing address

4905 S 107TH Ave
Omaha, NE 68127-1965
Phone (402) 393-9459

Other identifiers 2

IdentifierTypeStateIssuer
14027OtherIABCBS IA PROVIDER #
0140277MedicaidIA

National Provider Directory

National Provider Directory

Locations

4905 S 107th Ave
Omaha, NE 68127
Phone (402) 243-1526

Practitioners & affiliated clinicians

Practitioners 2

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922185487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 S 107TH AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271965",
            "telephone_number": "402-393-9459",
            "fax_number": "402-397-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 RIDGE ST",
            "address_2": "SUITE 314",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034643",
            "telephone_number": "712-322-0253",
            "fax_number": "712-322-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP W. MEYER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-322-0253",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "20597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IA PROVIDER #",
            "identifier": "14027",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0140277",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.