Individual provider Active NPI

Andrea Nicole Morris, MD

  • Pediatrics Physician
  • Columbus, MS
National Provider Identifier
1114156858
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
22169 Issued in MS
Practice address
2600 Fifth Street North
Columbus, MS 39705
Phone
(662) 244-2960
Fax
(662) 244-2964
NPI assigned
Jul 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 22169 MS Primary

Addresses

Primary practice location

2600 Fifth Street North
Columbus, MS 39705

Mailing address

P.O. Box 405827
Atlanta, GA 30384-5827

Other identifiers 1

IdentifierTypeStateIssuer
64623MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130621000153 MS Practitioner - Pediatric Medicine 6901045095 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22169MSMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc Pediatrics CurrentSince Sep 2, 2012 Accepting new patients
Baptist Memorial Medical Group Inc CurrentSince Sep 2, 2012 Accepting new patients
Baptist Memorial Hospital - Golden Triangle Inc. Past Accepting new patients

Locations

200 Park Creek Dr
Columbus, MS 39705
Phone (662) 327-8410

255 Baptist Blvd
Ste 301
Columbus, MS 39705
Phone (662) 244-2288

2600 5th St N
Columbus, MS 39705
Phone (662) 241-4223

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

Interoperability endpoints

  • Direct secure messaging: amorris4537@direct.bmhcc.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477008000000",
    "number": "1114156858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 FIFTH STREET NORTH",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39705",
            "telephone_number": "662-244-2960",
            "fax_number": "662-244-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "ANDREA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2016-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "22169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64623",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

Verify at the official NPI Registry.