Organization Active NPI

Ash Morrow Medical Center Inc

  • Cardiovascular Disease Physician
  • Forest Park, GA
National Provider Identifier
1073681334
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
033410 Issued in GA
Legal business name
ASH MORROW MEDICAL CENTER INC
Practice address
769 Morrow Rd
Forest Park, GA 30297-3240
Phone
(770) 961-4646
Fax
(404) 363-4938
NPI assigned
Dec 2, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Clarence E Morgan Jr., M.D.NPI 1609939834
Title
President
Phone
(770) 961-4646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 033410 GA Primary

Addresses

Primary practice location

769 Morrow Rd
Forest Park, GA 30297-3240

Mailing address

769 Morrow Rd
Forest Park, GA 30297-3240
Phone (770) 961-4646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120314000163 GA Part B Supplier - Clinic/Group Practice 5294994042 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Park, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2037109Ash Morrow Medical Center, Inc769 Morrow Road, Forest Park, GA 30297Certificate of waiverFeb 20, 2028

National Provider Directory

National Provider Directory

Locations

769 Morrow Rd
Forest Park, GA 30297
Phone (770) 703-7746

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073681334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 MORROW RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973240",
            "telephone_number": "770-961-4646",
            "fax_number": "404-363-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 MORROW RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302973240",
            "telephone_number": "770-961-4646",
            "fax_number": "404-363-4938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASH MORROW MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-961-4646",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "033410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.