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MERIDIAN ADVANCED PSYCHIATRY , LLC
NPI 1609412683
Psychiatry & Neurology - Addiction Medicine in Meridan, ID

Active since November 25, 2019CLIA Certified · 5 labs
1672 S WOODSAGE AVE., MERIDAN, ID 83642(208) 515-2273(208) 515-2274 Get Directions Write a Review

NPPES record last updated: May 12, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 12, 2020, May 7, 2020, Nov 25, 2019 (3 updates tracked since 2019).

About Meridian Advanced Psychiatry , Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MERIDIAN ADVANCED PSYCHIATRY , LLC (NPI 1609412683) is a healthcare organization registered as an addiction medicine in Meridan, Idaho and active in the NPI registry since November 2019. The organization holds 5 active CLIA laboratory certificates, maintains a secondary practice location in Meridian, and lists Kevin Hulsey, Ceo, as its authorized official.

NPPES Registry Identity

NPI1609412683
Entity TypeOrganization
Primary Taxonomy2084A0401X
Legal Business NameMERIDIAN ADVANCED PSYCHIATRY , LLC
Location Address1672 S WOODSAGE AVE.Meridan, ID 83642
Mailing Address1672 S Woodsage Avenue, Suite #120Meridan, ID 83642 · (208) 515-2273 · Fax (208) 515-2274
Phone(208) 515-2273
Fax(208) 515-2274
Organization SubpartNo
Authorized OfficialKevin HulseyCeo · (208) 789-0202
Enumeration DateNovember 25, 2019
Last NPPES UpdateMay 12, 20203 updates tracked since enumeration
NPPES CertifiedMay 12, 2020
✔ NPI 1609412683 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Addiction MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2084A0401X
Definition
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
1672 S WOODSAGE AVE., Meridan, ID 83642
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Secondary Practice Location 1

Location 11660 S Woodsage AveMeridian, ID 83642-7670 · Phone (208) 515-2273 · Fax (208) 515-2274

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 13D2179364

Meridian Advanced Psychiatry LLC · Meridian, ID
Active · expires Feb 20, 2028
CLIA Number13D2179364
Laboratory TypeIndependent
Certificate Effective DateFebruary 21, 2026
Certificate Expiration DateFebruary 20, 2028
Laboratory DirectorKyle Ronnau Pmhnp Bc
Laboratory Phone(208) 515-2273
Laboratory LocationMeridian Advanced Psychiatry LLC1672 S Woodsage Ave Ste 120, Meridian, ID 83642
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2289026

Meridian Advanced Psychiatry - Emerald · Boise, ID
Active · expires Sep 4, 2027
CLIA Number13D2289026
Laboratory TypeIndependent
Certificate Effective DateSeptember 5, 2025
Certificate Expiration DateSeptember 4, 2027
Laboratory DirectorKyle Ronnau
Laboratory Phone(208) 515-2273
Laboratory LocationMeridian Advanced Psychiatry - Emerald6945 W Emerald St, Boise, ID 83704
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2282027

Meridian Advanced Psychiatry · Meridian, ID
Active · expires May 15, 2027
CLIA Number13D2282027
Laboratory TypeIndependent
Certificate Effective DateMay 16, 2025
Certificate Expiration DateMay 15, 2027
Laboratory DirectorKyle Ronnau
Laboratory Phone(208) 515-2273
Laboratory LocationMeridian Advanced Psychiatry4783 N Summit Way, Meridian, ID 83646
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2315305

Meridian Advanced Psychiatry - Nampa · Nampa, ID
Active · expires Dec 9, 2026
CLIA Number13D2315305
Laboratory TypeIndependent
Certificate Effective DateDecember 10, 2024
Certificate Expiration DateDecember 9, 2026
Laboratory DirectorKyle Ronnau
Laboratory Phone(208) 515-2273
Laboratory LocationMeridian Advanced Psychiatry - Nampa920 S Rising Sun Dr Ste B, Nampa, ID 83686
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 13D2195911

Meridian Advanced Psychiatry LLC · Caldwell, ID
Active · expires Oct 12, 2026
CLIA Number13D2195911
Laboratory TypeIndependent
Certificate Effective DateOctober 13, 2024
Certificate Expiration DateOctober 12, 2026
Laboratory DirectorKyle Ronnau Pmhnp-Bc
Laboratory Phone(208) 515-2273
Laboratory LocationMeridian Advanced Psychiatry LLC211 E Logan St Ste 301, Caldwell, ID 83605
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Meridian Advanced Psychiatry , LLC's NPI number?

The NPI number for Meridian Advanced Psychiatry , LLC is 1609412683. It was assigned to this organization in the NPPES registry on November 25, 2019.

Where is Meridian Advanced Psychiatry , LLC located?

Meridian Advanced Psychiatry , LLC is located at 1672 S Woodsage Ave., Meridan, ID 83642. The listed phone number is (208) 515-2273.

What is Meridian Advanced Psychiatry , LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Addiction Medicine, with taxonomy code 2084A0401X.

Does Meridian Advanced Psychiatry , LLC hold CLIA laboratory certificates?

Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Meridian Advanced Psychiatry , LLC accept?

Health plans from Moda Health Plan, Inc. list Meridian Advanced Psychiatry , LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Meridian Advanced Psychiatry , LLC was last updated on May 12, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.