Active NPI
Krystal Lee Morris, PT
- Physical Therapist
- Fort Stewart, GA
National Provider Identifier
1114067964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 017083
- Practice address
- 1061 Harmon Ave
Fort Stewart, GA 31314-5641 - Phone
- (435) 696-5912
- NPI assigned
- Feb 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | PT017083 | PA | |
| Physical Therapist | 225100000X | 017083 | PA | Primary |
Addresses
Primary practice location
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Mailing address
941 Burr St Apt E
Fort Benning, GA 31905-8770
Other practice location 1
7950 Martin Loop
Fort Benning, GA 31905-5647
Phone (706) 544-1442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT017083 | Other | PA | PT LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT017083 | PA | MD | Military Health Care Provider |
| 017083 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555891200000",
"number": "1114067964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "941 BURR ST APT E",
"city": "FORT BENNING",
"state": "GA",
"postal_code": "319058770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1061 HARMON AVE",
"city": "FORT STEWART",
"state": "GA",
"postal_code": "313145641",
"telephone_number": "435-696-5912"
}
],
"practiceLocations": [
{
"address_1": "7950 Martin Loop",
"address_purpose": "LOCATION",
"city": "Fort Benning",
"state": "GA",
"postal_code": "319055647",
"country_code": "US",
"telephone_number": "706-544-1442",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORRIS",
"first_name": "KRYSTAL",
"middle_name": "LEE",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2019-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "PA",
"license": "PT017083",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "017083",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "PT017083",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Stewart, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.