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Join the Meridian Network
Please complete the form below:
Contact Information
First Name:
Last Name:
Phone Number:
Email Address:
Provider Information
Legal Entity Name:
ATTN:
Street Address:
Street Address 2:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Main
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Verginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Service Location(s):
Hold the Ctrl key and click to select multiple states
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Main
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Verginia
Washington
West Virginia
Wisconsin
Wyoming
Provider Identification
Tax ID:
NPI:
Medicaid Number:
Provider Specialty:
Acute Medical Detox-Inpatient
Adolescent Medicine
Adolescent Programs
Adolescent Psychiatry
Allergy
Allergy\Immunology
Ambulance
Ambulatory Surgery
Anatom & Clinic Path
Anatomic Pathology
Anesthesiology
Asthma Control-Temp
Athletic\Sports Medicine
Audiology
Bariatrics
Behavioral Medicine
Behavioral Medicine - Children
Behavioral Medicine - Substance Abuse
Behavoral Modification
Blood Banking
Cardiac
Cardiology
Cardiovascular Disease
Cardiovascular Surgery
Chemical Dependency
Child Psychiatry
Chiropractic
Chronic Pain Management
Clin Cardiac Electro
Clinical Pathology
Colon & Rectal Surg
Critical Care
Critical Care Medicine
Cytopathology
DME
Dematopathology
Dentistry & Oral Surgery
Dermatology
Dermatopathology
Developmental Disabilities
Diabetic Training
Diabities Center
Diagnos\Nuclear Radi
Diagnostic Radiology
Dialysis
Dietician
Eating Disorders
Ect Therapy
Emergency Care
Emergency Medicine
Emergency Services
Endocrinology
Endocrinology & Metabolism
Family Nurse Practitioner
Family Planning
Family Practice
Family Therapy
Federally Qualified Health Center
Forensic Pathology
Freestand Outpt Surg
Gastroenterology
General Care
General Practice
General Prevent Med
General Surgery
Geriatric Medicine
Geriatric Mental Health
Geriatric Psychiatry
Gynecologic Oncology
Gynecology only
Hearing Aid Provider
Hematology,Oncology
Hematology-Pathology
Home Fetal Monitoring
Home Health Care
Hospice
Hospital
Hospital Inpatient
Hospital Outpatient
Industrial Medicine
Infectious Diseases
Inpatient Internal Medicine
Internal Medicine
Internal Medicine Pediatrics
Laboratory
Mat & Fetal Medicine
Maternal Infant Health Program
Maternal\Fetal Medicine
Med Surg Eye Care
Medical Genetics
Medical Microbiology
Mental Health
Mental Health Therapist
Midwifery
Mood Disorders
Neonatal\Perinatal M
Nephrology
Neurological Surgery
Neurology
Neuropathology
Neuropsychology
Neurosurgery
Non-emergency transportation
Nuclear Medicine
Nuclear Radiology
Nurse Anesthetist
Nursing Care
Nutritional Consultation
OB\GYN
Obstetrics
Occupational Medicin
Occupational Therapy
Oncology
Ophthalmology
Optometry
Oral Surgery
Oral\Maxillofacial
Orthopedic
Orthopedic Hand Surgery
Orthopedic Surgery
Osteopathic Manipulative Medicine
Other-Temporary
Otolaryngology
Otology & Otorhinola
Otorhinolaryngology
Outpatient Detoxification
Pathology
Ped Hematol\Oncology
Ped Phys\Med Rehab
Ped Rheumatology
Ped.Crit.Care Medic.
Pedia Infect Disease
Pediatric Allergy
Pediatric Cardiology
Pediatric Dermatology
Pediatric Emerg Med
Pediatric Endocrinol
Pediatric Gastroent
Pediatric Genetics
Pediatric Icu
Pediatric Immunology
Pediatric Nephrology
Pediatric Neurology
Pediatric Neurosurg
Pediatric Nurse Prac
Pediatric Opthalmol
Pediatric Orthoped
Pediatric Otolaryngology
Pediatric Pathology
Pediatric Pulmonolog
Pediatric Surgery
Pediatric Urologists
Pediatrics Hospital
Pediatrics Physician
Perinatology
Pharmacy
Physiatry
Physical Medicine
Physical Therapist
Physical Therapy
Physical\Rehabilitative Medicine
Physician Assistant
Plastic Surgery
Podiatry
Preventive Medicine
Proctologist
Prosthetics\Orthotics
Psychiatry
Psychiatry & Neurology
Psychology
Psychosomatic Medicine
Public Health Clinic
Public Health Department
Pulmonary Disease
Pulmonary Medicine
Radiation Oncology
Radioisotopic Pathol
Radiology
Radiology, Pediatric
Rehabilitation Agency
Reprod Endocrinology
Reproductive Genetics
Rheumatology
Sleep Medicine
Speech & Language Pathology
Speech Pathology
Speech Therapy
Speech and Language Disorders
Spinal Cord
Subacute Medical Detox-Inpatient
Surgery, Traumatic
Surgery, Urological
Surgical Crit. Care
Therapeutic Radiology
Therapy\Rehab Lock
Thoracic Cardiovascular Surgery
Thoracic Surgery
Transplant Surgery
Urgent Care
Urgent Care Pediatrics
Urology
Vascular Surgery