MERIDIAN PRIMARY CARE CLINIC (NPI# 1689165052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689165052 |
| Entity Type | Organization |
| Organization Name | MERIDIAN PRIMARY CARE CLINIC |
| Practice Address |
439 Sw Michigan St Lake City FL 32025 |
| Mailing Address |
4300 Sw 13th St Gainesville FL 32608-4006 |
| Practice Telephone | 3523745600 |
| Mailing Telephone | 3523745600 |
| Mailing Fax Number | 3522440280 |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | LAUREN COHN (SVP QI / CPO) |
| Authorized Official Telephone | 3523745600 |
| Is Organization Subpart | Y |
| Parent Organization Name | MERIDIAN BEHAVIORAL HEALTHCARE INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | HCC | FL | Allopathic & Osteopathic Physicians |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
HCC | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 016511900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740653526 | Meridian Primary Care Clinic | Family Medicine | 4300 Sw 13th St, Gainesville, FL 32608 | 2015-11-03 |
| Street Address |
439 SW MICHIGAN ST |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548249360 | Anton Frans Kootte | Social Worker | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2006-01-11 |
| 1689275216 | Shawnta Walker | Counselor | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-11-02 |
| 1790384287 | Stormy B Waldron | Registered Nurse | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-10-26 |
| 1639778038 | Tyesha L Foster | Nurse's Aide | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-10-19 |
| 1831797919 | Sylvia Vg Youngblood | Nurse's Aide | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-10-12 |
| 1831797034 | Brittany L Ford | Nurse's Aide | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-10-12 |
| 1063019909 | Sade Debra Law | Counselor | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-10-05 |
| 1184231060 | Jennifer P Moon | Counselor | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-09-25 |
| 1326653833 | Aloralee D Avery | Nurse's Aide | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-09-11 |
| 1225641236 | Jalisa D Middleton | Counselor | 439 Sw Michigan St, Lake City, FL 32025-0440 | 2020-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1316477060 | Lake City Medical Associates 2017, LLC | Clinic/Center | 130 S Acline St, Lake City, SC 29560-2633 | 2017-06-15 |
| 1992732432 | Graham Clinic Inc. | Clinic/Center | 1278 Moore St, Lake City, SC 29560-4601 | 2006-06-28 |
| 1952896151 | Lake City Primary Care PC | Clinic/Center | 1866 S Morey Rd, Lake City, MI 49651 | 2018-06-29 |
| 1962641498 | Baya Bariatrics Urgent Care | Clinic/Center | 373 Se Country Club Rd, Lake City, FL 32025-4987 | 2009-02-06 |
| 1285822981 | Internal Medicine of Lake City Pa | Clinic/Center | 289 Sw Stonegate Ter, Suite 104, Lake City, FL 32024-3456 | 2007-10-09 |
| 1114149234 | Ernest De Leon, Md, Pa | Clinic/Center | 4225 Nw American Ln, Lake City, FL 32055-4881 | 2007-05-02 |
| 1164463659 | Mayo Clinic Health System-lake City | Clinic/Center | 500 W Grant St, Lake City, MN 55041-1143 | 2006-06-08 |
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|---|---|---|---|---|
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| 1699380329 | Premier Health System LLC | Clinic/Center | 12970 Sw 133rd Ct Ste A, Miami, FL 33186-5806 | 2020-09-10 |
| 1093328163 | Sunmed Group LLC | Clinic/Center | 2499 Glades Rd Ste 305a, Boca Raton, FL 33431-7202 | 2020-08-28 |
| 1790398246 | Emc 360, LLC | Clinic/Center | 1008 Juliette Blvd, Mount Dora, FL 32757-6500 | 2020-08-25 |
| 1720690704 | Celena Vinent Carbonell M.d., P.a. | Clinic/Center | 1001 N Macdill Ave Ste D, Tampa, FL 33607-5152 | 2020-08-20 |
| 1548871866 | 1st Call Primary Care, LLC | Clinic/Center | 955 S Woodland Blvd Ste A1, Deland, FL 32720-7321 | 2020-08-11 |
| 1912517152 | Curos Inc | Clinic/Center | 1425 Sw 8th Ct, Ft Lauderdale, FL 33312-7291 | 2020-08-03 |
| 1104436492 | Caretinuum Health | Clinic/Center | 3208 W Lake Mary Blvd Ste 1710, Lake Mary, FL 32746-3467 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.