Jordan Renee Morrison, OPTICIAN

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

Sex

Female

Sole proprietor

Yes

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.

• Loraine Thomas

  • Optician
  • Bridgeport, WV
  • NPI 1053917468
  NPD Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 9, 2020.

{
    "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": []
}

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• Mountain State Medical Specialties, PLLC

• All providers in Bridgeport, WV
• Optician in West Virginia

• 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.