Individual provider Active NPI

Morgan Janessa Neilon, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1104127729
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
401348 Issued in NY
Practice address
620 Erie Blvd W
Suite 204
Syracuse, NY 13204-2445
Phone
(315) 445-1200
Fax
(315) 445-1201
NPI assigned
Nov 12, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 401348 NY Primary

Addresses

Primary practice location

620 Erie Blvd W
Suite 204
Syracuse, NY 13204-2445

Mailing address

620 Erie Blvd W Ste 204
Syracuse, NY 13204-2457
Phone (315) 572-0802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
401348NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1104127729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W STE 204",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042457",
            "telephone_number": "315-572-0802",
            "fax_number": "315-445-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 ERIE BLVD W",
            "address_2": "SUITE 204",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042445",
            "telephone_number": "315-445-1200",
            "fax_number": "315-445-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILON",
        "first_name": "MORGAN",
        "middle_name": "JANESSA",
        "name_prefix": "Ms.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-12",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "401348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.