Individual provider Active NPI

Krystal Lee Morris, PT

  • Physical Therapist
  • Fort Stewart, GA
National Provider Identifier
1114067964
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
017083 Issued in PA
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

Updated by the provider on Apr 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PT017083OtherPAPT 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

LicenseStateTypeSpecialty
PT017083PAMDMilitary Health Care Provider
017083PAMDPhysical 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.

Verify at the official NPI Registry.