Active NPI
Jon Raymond Morgan, MD
- Dermatology Physician
- Palm Beach Gardens, FL
National Provider Identifier
1104885474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 6280
- Practice address
- 11505 Fairchild Gardens Ave
Suite 101
Palm Beach Gardens, FL 33410-2847 - Phone
- (561) 493-8314
- Fax
- (561) 493-8316
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 6280 | SC | Primary |
Addresses
Primary practice location
11505 Fairchild Gardens Ave
Suite 101
Palm Beach Gardens, FL 33410-2847
Mailing address
4800 N Federal Hwy
Suite C101
Boca Raton, FL 33431-5188
Phone (561) 886-0970
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6280 | SC | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Dermatology GRP | Dermatology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dermatology Physician
- Columbia, SC
- NPI 1083693857
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398988800000",
"number": "1104885474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 N FEDERAL HWY",
"address_2": "SUITE C101",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334315188",
"telephone_number": "561-886-0970",
"fax_number": "561-886-0980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11505 FAIRCHILD GARDENS AVE",
"address_2": "SUITE 101",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334102847",
"telephone_number": "561-493-8314",
"fax_number": "561-493-8316"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORGAN",
"first_name": "JON",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2014-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "SC",
"license": "6280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.