Individual provider Active NPI

Theresa Ann Morris, PA

  • Physician Assistant
  • Beaufort, SC
National Provider Identifier
1114906492
Registry record updated Dec 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
949 Issued in SC
Practice address
27 Kemmerlin LN
Primecare Health Center
Beaufort, SC 29907-2702
Phone
(843) 524-2100
NPI assigned
Jan 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 949 SC Primary

Addresses

Primary practice location

27 Kemmerlin LN
Primecare Health Center
Beaufort, SC 29907-2702

Mailing address

27 Kemmerlin LN
Primecare Health Center
Beaufort, SC 29907-2702
Phone (843) 524-2100

Other identifiers 1

IdentifierTypeStateIssuer
0241PAMedicaidSC

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
949SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Primary Care Partners, LLC Current Accepting new patients
Primecare Health Center PA Past Accepting new patients
Bestpractices of South Carolina, PC Past Accepting new patients

Locations

60 Exchange St
Ste B7
Richmond Hill, GA 31324
Phone (912) 756-2273

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1114906492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 KEMMERLIN LN",
            "address_2": "PRIMECARE HEALTH CENTER",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072702",
            "telephone_number": "843-524-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 KEMMERLIN LN",
            "address_2": "PRIMECARE HEALTH CENTER",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072702",
            "telephone_number": "843-524-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0241PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.