Individual provider Active NPI

Merindy Grace Morgenson, MD

  • Family Medicine Physician
  • Shattuck, OK
National Provider Identifier
1063518876
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
37899 Issued in OK
Practice address
905 S Main St
Shattuck, OK 73858-9205
Phone
(580) 938-2551
NPI assigned
Sep 16, 2006
Last updated
Dec 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 44920 CO
Family Medicine Physician 207Q00000X 37899 OK Primary
Obstetrics & Gynecology Physician 207V00000X 44920 CO

Addresses

Primary practice location

905 S Main St
Shattuck, OK 73858-9205

Mailing address

PO Box 222006
Dallas, TX 75222-2006
Phone (972) 934-3200

Other practice location 1

2201 San Juan Ave
LA Junta, CO 81050-3323
Phone (719) 384-8181

Other identifiers 1

IdentifierTypeStateIssuer
63282267MedicaidCO

Other names 1

  • Merindy Grace Morgenson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220002516 OK Practitioner - Family Practice 5799702007 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37899OKMDFamily Medicine Physician
44920COMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HCC Duncan Inc CurrentSince Nov 1, 2022 Accepting new patients
Hospital Care Consultants, Inc CurrentSince Dec 21, 2022 Accepting new patients
Valley-Wide Health Systems, Inc. Past Accepting new patients

Locations

1407 N Whisenant Dr
Duncan, OK 73533
Phone (580) 251-8458

213 E Redwood Ave
Sallisaw, OK 74955
Phone (918) 774-1100

905 S Main St
Shattuck, OK 73858
Phone (580) 938-2551

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1063518876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 222006",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752222006",
            "telephone_number": "972-934-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 S MAIN ST",
            "city": "SHATTUCK",
            "state": "OK",
            "postal_code": "738589205",
            "telephone_number": "580-938-2551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 San Juan Ave",
            "address_purpose": "LOCATION",
            "city": "LA Junta",
            "state": "CO",
            "postal_code": "810503323",
            "country_code": "US",
            "telephone_number": "719-384-8181",
            "fax_number": "719-384-4872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORGENSON",
        "first_name": "MERINDY",
        "middle_name": "GRACE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "44920",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "37899",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "44920",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63282267",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERINDY",
            "last_name": "MORGENSON",
            "middle_name": "GRACE",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shattuck, OK

Sources for this page

Verify at the official NPI Registry.