Active NPI
Kirk Thomas Morris, DDS
- Pediatric Dentistry
- Kennewick, WA
National Provider Identifier
1053608331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 60372817
- Practice address
- 2611 S Quillan PL
Kennewick, WA 99338-1899 - Phone
- (509) 585-5437
- Fax
- (509) 585-5438
- NPI assigned
- Jul 7, 2011
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 60372817 | WA | Primary |
Addresses
Primary practice location
2611 S Quillan PL
Kennewick, WA 99338-1899
Mailing address
2611 S Quillan PL
Kennewick, WA 99338-1899
Phone (509) 585-5437
Other practice location 1
910 Madison Ave
Ste. 1031
Memphis, TN 38103-3403
Phone (901) 448-5364
Other practice location 2
39 Columbia Point Dr
Richland, WA 99352-4375
Phone (509) 946-9999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171128002706 | WA | Order and Referring Only - Dentist | 4385901412 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60372817 | WA | MD | Pediatric Dentist |
Interoperability endpoints
- kmorris18506@yvfwc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1053608331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2611 S QUILLAN PL",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993381899",
"telephone_number": "509-585-5437",
"fax_number": "509-585-5438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 S QUILLAN PL",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993381899",
"telephone_number": "509-585-5437",
"fax_number": "509-585-5438"
}
],
"practiceLocations": [
{
"address_1": "910 Madison Ave",
"address_2": "Ste. 1031",
"address_purpose": "LOCATION",
"city": "Memphis",
"state": "TN",
"postal_code": "381033403",
"country_code": "US",
"telephone_number": "901-448-5364",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "39 Columbia Point Dr",
"address_purpose": "LOCATION",
"city": "Richland",
"state": "WA",
"postal_code": "993524375",
"country_code": "US",
"telephone_number": "509-946-9999",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORRIS",
"first_name": "KIRK",
"middle_name": "THOMAS",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-07",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "60372817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.