Individual provider Active NPI

Connie Payongayong Morales

  • Family Nurse Practitioner
  • Gadsden, AL
National Provider Identifier
1063933711
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-111392 Issued in AL
Practice address
427 S 3Rd St
Gadsden, AL 35901-5210
Phone
(256) 543-3508
NPI assigned
Jul 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-111392 AL Primary

Addresses

Primary practice location

427 S 3Rd St
Gadsden, AL 35901-5210

Mailing address

393 Williams Ave
Rainbow City, AL 35906-6551
Phone (256) 328-4189

Other practice location 1

427 S 3rd St
Gadsden, AL 35901-5210
Phone (256) 543-3508

Other practice location 2

309 W Grand Ave
Rainbow City, AL 35906-3241
Phone (256) 442-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119001685 AL Practitioner - Nurse Practitioner 2163843475 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services-Gadsden Physician Management LLC CurrentSince Dec 11, 2023 Accepting new patients
Edward F. Hwang, M.D. Past Accepting new patients

Locations

515 S 3rd St
Gadsden, AL 35901
Phone (256) 413-6520

600 S 3rd St
Gadsden, AL 35901
Phone (256) 543-5200

1642A Pelham Rd S
Jacksonville, AL 36265
Phone (256) 543-1222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10998/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063933711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 WILLIAMS AVE",
            "city": "RAINBOW CITY",
            "state": "AL",
            "postal_code": "359066551",
            "telephone_number": "256-328-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 S 3RD ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015210",
            "telephone_number": "256-543-3508"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "427 S 3rd St",
            "address_purpose": "LOCATION",
            "city": "Gadsden",
            "state": "AL",
            "postal_code": "359015210",
            "country_code": "US",
            "telephone_number": "256-543-3508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Rainbow City",
            "state": "AL",
            "postal_code": "359063241",
            "country_code": "US",
            "telephone_number": "256-442-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORALES",
        "first_name": "CONNIE",
        "middle_name": "PAYONGAYONG",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-111392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

Verify at the official NPI Registry.