Joseph Roman Mort

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS0000010524 Issued in TN

Practice address

131 Indian Lake Blvd Ste 100
Hendersonville, TN 37075

Phone

(615) 822-8403

NPI assigned

Apr 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 10, 2022 through Nov 10, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Daniel C. Burchfield, DMD Et Al PTR.

  • Oral and Maxillofacial Surgery (Dentist)
  • Hendersonville, TN
  • NPI 1861474694
  NPD (past)

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1114346137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 INDIAN LAKE BLVD STE 100",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370756207",
            "telephone_number": "615-822-8403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 INDIAN LAKE BLVD STE 100",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "37075",
            "telephone_number": "615-822-8403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORT",
        "first_name": "JOSEPH",
        "middle_name": "ROMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "DS0000010524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Scott Morris, MD
• James Richard Morris Jr., D.M.D
• Monica Lee Morris, COTA L
• Christine Caughron Morrow, M.S.CCC-SLP
• Alex John Morsey, APRN
• Jacob Mortemore
• Brooklyn Mosley
• Gregg Andrew Motz, MD
• Sarah Brooke Mueller, R.D.
• Saigh Mullins

• Oral and Maxillofacial Surgery (Dentist) in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.