Active NPI
Mark Morgan, PT
- Orthopedic Physical Therapist
- Hailey, ID
National Provider Identifier
1013137850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT-647
- Practice address
- 221 S River St
Hailey, ID 83333-8436 - Phone
- (208) 788-0061
- Fax
- (208) 788-2211
- NPI assigned
- Apr 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | PT-647 | ID | Primary |
Addresses
Primary practice location
221 S River St
Hailey, ID 83333-8436
Mailing address
PO Box 1191
Hailey, ID 83333-1191
Phone (208) 788-0061
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010025485 | Other | ID | BLUE SHIELD PROVIDER NUM. |
| 805397000 | Medicaid | ID | |
| T6251 | Other | ID | BLUE CROSS PROVIDER NUM. |
| P00060576 | Other | ID | RAILROAD MEDICARE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-647 | ID | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322870400000",
"number": "1013137850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1191",
"city": "HAILEY",
"state": "ID",
"postal_code": "833331191",
"telephone_number": "208-788-0061",
"fax_number": "208-788-2211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 S RIVER ST",
"city": "HAILEY",
"state": "ID",
"postal_code": "833338436",
"telephone_number": "208-788-0061",
"fax_number": "208-788-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORGAN",
"first_name": "MARK",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-26",
"last_updated": "2011-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "ID",
"license": "PT-647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER NUM.",
"identifier": "000010025485",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805397000",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUM.",
"identifier": "T6251",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "P00060576",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hailey, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.