Individual provider Active NPI

William Drew Morgan, P.T.

  • Physical Therapist
  • Conway, AR
National Provider Identifier
1053561464
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT3089 Issued in AR
Practice address
3605 College Ave
Conway, AR 72034-7377
Phone
(501) 327-2235
Fax
(501) 327-1601
NPI assigned
Sep 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT3089 AR Primary

Addresses

Primary practice location

3605 College Ave
Conway, AR 72034-7377

Mailing address

2100 W Main St
Russellville, AR 72801-2758
Phone (479) 968-2525

Other identifiers 4

IdentifierTypeStateIssuer
A002OtherARTRICARE
5A963C556OtherARBLUE CROSS BLUE SHIELD
P00685672OtherARPALMETTO RR
175205721MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081007000176 AR Practitioner - Physical Therapist in Private Practice 7416025291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
River Valley Therapy and Sports Medicine IncGroup PAC ID 1850294018, 31 clinicians

Practice addresses (Care Compare)

2100 W Main St
Russellville, AR 72801-2758
Phone (479) 968-2525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Therapy & Sports Medicine Inc Physical Therapist CurrentSince Jun 23, 2015 Accepting new patients
Maumelle Physical Therapy, Inc. Physical Therapist PastSince Sep 21, 2009 Accepting new patients
Advanced Physical Therapy Inc Physical Therapist PastSince Jan 1, 2006 Accepting new patients

Locations

3605 College Ave
Conway, AR 72034
Phone (501) 327-2235

2100 W Main St
Russellville, AR 72801
Phone (479) 968-2525

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441843200000",
    "number": "1053561464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012758",
            "telephone_number": "479-968-2525",
            "fax_number": "479-968-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347377",
            "telephone_number": "501-327-2235",
            "fax_number": "501-327-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "WILLIAM",
        "middle_name": "DREW",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2015-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT3089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5A963C556",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO RR",
            "identifier": "P00685672",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175205721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.