Michael J Morris, OD
Individual provider Active NPI Optometrist · Louisville, KY
NPI 1124072871 · NPPES record last updated Apr 29, 2019
Key facts
- NPI
- 1124072871
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1487DT (KY)
- Practice address
- 11901 Standiford Plaza Dr
Louisville, KY 40229-5906 - Phone
- (502) 968-2720
- Fax
- (502) 968-2721
- NPI assigned
- May 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 24
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ky Doctors of Optometry, PLLC
Practice addresses (Care Compare)
1609 N Dixie Ave
Suite 100
Elizabethtown, KY 42701-7494
Phone (270) 765-7372
4655 Outer Loop
Louisville, KY 40219-3970
Phone (502) 966-2020
500 Winchester Ave
Suite 810
Ashland, KY 41101-7362
Phone (606) 324-3672
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060703000049 | KY | Practitioner - Optometry | 6901818244 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1487 | KY | MD | Professional Counselor |
| 1487DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ky Doctors of Optometry, PLLC | Optometrist | Current |
Accepting new patients |
| Vision Tek, LLC | Optometrist | Past | Accepting new patients |
| Ky Doctors of Optometry, PLLC | Optometrist | Past | Accepting new patients |
| Ky Doctors of Optometry, PLLC | Past | Accepting new patients |
Locations
4655 Outer Loop
Louisville, KY 40219
Phone (502) 966-2020
175 E Houston St
San Antonio, TX 78205
Phone (210) 524-6982
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1487DT | KY | Yes |
Addresses
Primary practice location
11901 Standiford Plaza Dr
Louisville, KY 40229-5906
Mailing address
PO Box 667
Hillview, KY 40129-0667
Phone (502) 968-2720
Other practice location 1
545 Conestoga Pkwy
Shepherdsville, KY 40165-6666
Phone (502) 968-2720
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77000552 | Medicaid | KY |
NPI Registry JSON
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556496000000",
"number": "1124072871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 667",
"city": "HILLVIEW",
"state": "KY",
"postal_code": "401290667",
"telephone_number": "502-968-2720",
"fax_number": "029-682-7215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11901 STANDIFORD PLAZA DR",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402295906",
"telephone_number": "502-968-2720",
"fax_number": "502-968-2721"
}
],
"practiceLocations": [
{
"address_1": "545 Conestoga Pkwy",
"address_purpose": "LOCATION",
"city": "Shepherdsville",
"state": "KY",
"postal_code": "401656666",
"country_code": "US",
"telephone_number": "502-968-2720",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MORRIS",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2019-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KY",
"license": "1487DT",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77000552",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.