MERIDIAN PEDIATRIC EXTENDED CARE LLC (NPI# 1609259936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609259936 |
| Entity Type | Organization |
| Organization Name | MERIDIAN PEDIATRIC EXTENDED CARE LLC |
| Practice Address |
3850 Highway 45 N Meridian MS 39301-1517 |
| Practice Telephone | 6019120373 |
| Practice Fax Number | 6019107521 |
| Mailing Telephone | 6019120373 |
| Mailing Fax Number | 6019107521 |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-06 |
| Authorized Official Name | ASHLEY HAMMOND (ADMINISTRATOR) |
| Authorized Official Telephone | 6019120373 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
Nursing & Custodial Care Facilities |
| Street Address |
3850 HIGHWAY 45 N |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39301-1517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851818652 | Joy Tiley Marvin | Occupational Therapist | 3850 Highway 45 N, Meridian, MS 39301-1517 | 2017-08-23 |
| 1285174177 | Morgan Hutto Bernd | Occupational Therapist | 3850 Highway 45 N, Meridian, MS 39301-1517 | 2017-02-27 |
| 1245684307 | Allison Carroll | Occupational Therapist | 3850 Highway 45 N, Meridian, MS 39301-1517 | 2016-04-14 |
| 1376916247 | Aegis Group Practice LLC | Physical Therapist | 3850 Highway 45 N, Meridian, MS 39301-1517 | 2015-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407460439 | Kayla Lee Monsour | Pharmacist | 1415 24th Avenue, Meridian, MS 39301 | 2020-09-08 |
| 1306478359 | K&r Optical Solutions Corporation | Eyewear Supplier (Equipment, not the service) | 3126 8th St., Suite A, Meridian, MS 39301 | 2020-02-07 |
| 1912537317 | Courtney M Hollie | Counselor | 1054 Ms-19, Meridian, MS 39301 | 2020-01-24 |
| 1932636495 | Rcg Mississippi, Inc. | Clinic/Center | 1300 38th Ave E, Meridian, MS 39301 | 2017-05-16 |
| 1811428915 | Tierria Mcglothin | Nurse Practitioner | 1054 Highway 19 S, Meridian, MS 39301 | 2017-03-21 |
| 1154869303 | Lindsay Nemanich | Physical Therapist | 3716 Ms-39, Meridian, MS 39301 | 2017-02-08 |
| 1700323599 | Wal-mart Stores East Lp | Pharmacy | 3310-a Highway 39 North, Meridian, MS 39301 | 2017-01-31 |
| 1972977460 | Southeast Pharmacy LLC | Pharmacy | 2402 Long Creek Road, Meridian, MS 39301 | 2015-11-20 |
| 1235508342 | East Mississippi Oral & Facial Surgery, LLC | Clinic/Center | 1212 24th Avenue, Meridian, MS 39301 | 2015-09-18 |
| 1831580778 | Clarkdale Pharmacy and Gifts LLC | Pharmacy | 6935c Hwy 145, Meridian, MS 39301 | 2015-02-13 |
| Find all providers in zip 39301 | ||||
| Taxonomy Code | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043858053 | Pediatric Haven | Skilled Nursing Facility | 112 Westfalen Drive, Canton, MS 39046 | 2019-12-20 |
| 1588104814 | Jackson County Pediatric Extended Care LLC | Skilled Nursing Facility | 2025 Jackson Ave, Pascagoula, MS 39567-4427 | 2017-03-06 |
| 1801256318 | Caring Hands Ppec of Vicksburg, LLC | Skilled Nursing Facility | 3419 Wisconsin Ave, Vicksburg, MS 39180-5330 | 2016-02-25 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1093198731 | Caring Hands Prescribed Pediatric | Skilled Nursing Facility | 371 Towne Center Pl, Ridgeland, MS 39157-4833 | 2015-06-30 |
| 1538249792 | Memorial Hospice Inc | Skilled Nursing Facility | 600 Ohio Street, Clarksdale, MS 38614 | 2006-10-16 |
| 1639606940 | Pediatrust Columbus, LLC | Skilled Nursing Facility | 306 Hospital Dr, Columbus, MS 39705-1935 | 2017-05-17 |
| 1437523511 | Delta Pediatric Care | Skilled Nursing Facility | 526 Fairview Ave, Greenville, MS 38701-5401 | 2015-11-30 |
| 1891107298 | Gulf Coast Pediatric Care LLC | Skilled Nursing Facility | 1285 Spring St, Gulfport, MS 39507-3423 | 2014-05-20 |
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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.