Active NPI
Roger Leon Morales, MD
- Pediatrics Physician
- Monroe, GA
National Provider Identifier
1043203227
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 055771
- Practice address
- 333 Alcovy St
Suite 1
Monroe, GA 30655-2180 - Phone
- (770) 267-4992
- Fax
- (770) 267-5710
- NPI assigned
- Aug 24, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 055771 | GA | Primary |
Addresses
Primary practice location
333 Alcovy St
Suite 1
Monroe, GA 30655-2180
Mailing address
PO Box 747
Monroe, GA 30655-0747
Phone (770) 267-4992
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 055771 | Other | GA | LICENSE |
| 209751 | Other | NY | LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 055771 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athens Regional Physician Services | Pediatrics | Past | Accepting new patients |
| Excellent Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CJDEAD/Endpoint/CJDEAD
- https://fhir4.healow.com/fhir/r4/CJDEAD
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Monroe, GA
- NPI 1104141837
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1296691200000",
"number": "1043203227",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 747",
"city": "MONROE",
"state": "GA",
"postal_code": "306550747",
"telephone_number": "770-267-4992",
"fax_number": "770-267-5710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 ALCOVY ST",
"address_2": "SUITE 1",
"city": "MONROE",
"state": "GA",
"postal_code": "306552180",
"telephone_number": "770-267-4992",
"fax_number": "770-267-5710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORALES",
"first_name": "ROGER",
"middle_name": "LEON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2011-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "055771",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "055771",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "209751",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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.