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

Active since November 25, 2019CLIA Certified · 4 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: October 25, 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 4 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
Open in Google Maps ↗

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., Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Meridian Advanced Psychiatry , Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

39

Medicare enrollment records show 39 clinicians reassign Medicare billing to Meridian Advanced Psychiatry , LLC, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 26 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 3

Nurse Practitioner37
Clinical Social Worker1
Family Practice1

Nearest to this location (20)

See all 39
Jarrod Crump, NP
Nurse Practitioner
NPI 1184240194
1672 S WOODSAGE AVE
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Mary Rankin, FNP
Nurse Practitioner
NPI 1154072205
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Kyle Ronnau, ARNP
Nurse Practitioner
NPI 1326584640
1672 S WOODSAGE AVENUE SUITE #120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Kyanne Wright, NP
Nurse Practitioner
NPI 1649991316
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Stephanie Lee, PMHNP-BC
Nurse Practitioner
NPI 1659962611
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOSSame address
Elizabeth Purcell
Nurse Practitioner
NPI 1972386092
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Kennedy Friesen, PMHNP-BC
Nurse Practitioner
NPI 1437982329
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Dianne Head, PMHNP-BC
Nurse Practitioner
NPI 1235935222
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Babatunde Olowu, PMHNP-BC
Nurse Practitioner
NPI 1790664035
1672 S WOODSAGE AVE
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Carmen Stephens, DNP-PMHNP
Nurse Practitioner
NPI 1639952476
1672 S WOODSAGE AVE
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Rebekah Svadlenka, NP
Nurse Practitioner
NPI 1063003895
1672 S WOODSAGE AVE STE 120
Meridian, ID 83642
(208) 515-2273
✔ PECOS✔ Accepts MedicareSame address
Jon Criswell, FNP-C
Nurse Practitioner
NPI 1881301075
63 W WILLOWBROOK DR
Meridian, ID 83646
(208) 888-7877
✔ PECOS✔ Accepts Medicare2.4 mi
Tony Bastar, NP
Nurse Practitioner
NPI 1992490254
58 W CHRISFIELD DR
Meridian, ID 83646
(208) 419-5300
✔ PECOS✔ Accepts Medicare2.6 mi
Esther Huffine
Nurse Practitioner
NPI 1326477258
2650 S EAGLE RD STE 100
Meridian, ID 83642
(986) 200-4290
✔ PECOS2.8 mi
Kjeranne Rummel, APRN-CNP
Nurse Practitioner
NPI 1376209460
3277 E LOUISE DR
Meridian, ID 83642
(208) 381-7335
✔ PECOS✔ Accepts Medicare2.8 mi
Jeremiah Clark, FNP-BC
Nurse Practitioner
NPI 1356123657
1526 W USTICK RD STE 110
Meridian, ID 83646
(208) 370-5888
✔ PECOS✔ Accepts Medicare3.1 mi
Rebecca Mcgrath, PMHNP
Nurse Practitioner
NPI 1457189326
3919 E OVERLAND RD
Meridian, ID 83642
(208) 506-3618
✔ PECOS✔ Accepts Medicare3.1 mi
Megan Brock, PMNHP
Nurse Practitioner
NPI 1083357651
2498 N STOKESBERRY PL STE 170
Meridian, ID 83646
(208) 918-0958
✔ PECOS✔ Accepts Medicare3.7 mi
Kirk Paolinelli, FNP
Nurse Practitioner
NPI 1235637240
4783 N SUMMIT WAY
Meridian, ID 83646
(208) 515-2273
✔ PECOS✔ Accepts Medicare4.0 mi
Jamie Bumgardner, PMHNP-BC
Nurse Practitioner
NPI 1679368658
6945 W EMERALD ST
Boise, ID 83704
(208) 515-2273
✔ PECOS✔ Accepts Medicare7.1 mi
See all 39 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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
Expired · 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.

Is Meridian Advanced Psychiatry , LLC enrolled in Medicare?

Yes. Meridian Advanced Psychiatry , LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Meridian Advanced Psychiatry , LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 39 clinicians in 3 Medicare specialties reassign their Medicare billing to Meridian Advanced Psychiatry , LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (37), Clinical Social Worker (1) and Family Practice (1). Of these, 11 practice at this address and 26 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Meridian Advanced Psychiatry , LLC hold CLIA laboratory certificates?

Yes. 4 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. and Molina Healthcare 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.