Individual provider Active NPI

Jordan Renee Morrison, OPTICIAN

  • Optician
  • Bridgeport, WV
National Provider Identifier
1114528148
Registry record updated Nov 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
139 Conference Center Way Ste 121
Bridgeport, WV 26330-9147
Phone
(304) 627-5588
NPI assigned
Nov 5, 2020
Last updated
Nov 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X WV Primary

Addresses

Primary practice location

139 Conference Center Way Ste 121
Bridgeport, WV 26330-9147

Mailing address

139 Conference Center Way Ste 121
Bridgeport, WV 26330-9147

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmorrison@lorainethomas.com

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

Practice roles

OrganizationSpecialtyStatusNew patients
Loraine Thomas Optician CurrentSince Dec 13, 2020 Accepting new patients

Locations

139 Conference Center Way
Ste 121
Bridgeport, WV 26330
Phone (304) 627-5588

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1114528148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 CONFERENCE CENTER WAY STE 121",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 CONFERENCE CENTER WAY STE 121",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309147",
            "telephone_number": "304-627-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "JORDAN",
        "middle_name": "RENEE",
        "credential": "OPTICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmorrison@lorainethomas.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "139 Conference Center Way Ste 121",
            "city": "Bridgeport",
            "state": "WV",
            "country_code": "US",
            "postal_code": "263309147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2020; 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.