Individual provider Active NPI

Gina Marie Morgan, D.P.M.

  • Podiatrist
  • Benton, AR
National Provider Identifier
1093949448
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
277 Issued in AR
Practice address
2711 Lakeside Dr
Benton, AR 72019-7092
Phone
(845) 461-9574
NPI assigned
May 13, 2009
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 277 AR Primary

Addresses

Primary practice location

2711 Lakeside Dr
Benton, AR 72019-7092

Mailing address

2711 Lakeside Dr
Benton, AR 72019-7092
Phone (845) 461-9574

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170908000254 AR Practitioner - Podiatry 0941487433 Reassigns benefits to 3 organizations
Practice locations: Benton, AR

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1010 N Ctr St
Lonoke, AR 72086-2005
Phone (501) 438-8075

1016 N Fourche Ave
Perryville, AR 72126-8545
Phone (501) 238-1284

1308 E Page Ave
Malvern, AR 72104-4518
Phone (501) 337-9820

20 Wilson Farm Rd
Greenbrier, AR 72058-9310
Phone (501) 679-8970

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue13
Removal of nail tissue76
Removal or shaving of skin growth14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
277ARMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Bibb MD PLLC CurrentSince Jun 1, 2021 Accepting new patients
Access Medical Clinic Arkansas LLC Single Specialty CurrentSince Jun 1, 2021 Accepting new patients
Access Medical Clinic Arkansas LTC LLC Single Specialty CurrentSince Dec 15, 2023 Accepting new patients
Access Medical Clinic Arkansas LLC Single Specialty CurrentSince Jun 1, 2021 Accepting new patients
Bradley Bibb, MD PLLC CurrentSince Jun 1, 2021 Accepting new patients
Bradley Bibb MD PLLC Single Specialty Current Accepting new patients
Access Medical Clinic Arkansas LTC LLC Single Specialty CurrentSince Dec 15, 2023 Accepting new patients

Locations

806 E Main St
Flippin, AR 72634
Phone (870) 219-7706

16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706

20 Wilson Farm Rd
Greenbrier, AR 72058
Phone (501) 679-8970

3809 E 9th St
Ste 15
Texarkana, AR 71854
Phone (870) 621-0080

106 N Van Buren St
Weiner, AR 72479
Phone (870) 605-0014

Interoperability endpoints

  • Direct secure messaging: gina.morgan.1@2424.direct.athenahealth.com

Organizations & group practices 9

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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1093949448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 LAKESIDE DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720197092",
            "telephone_number": "845-461-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 LAKESIDE DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720197092",
            "telephone_number": "845-461-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AR",
            "license": "277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.