Individual provider Active NPI

Morgan R Mockbee

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1124620455
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003224A Issued in IN
Practice address
1725 N Meridian St
Indianapolis, IN 46202-1403
Phone
(317) 396-2679
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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 10003224A IN Primary

Addresses

Primary practice location

1725 N Meridian St
Indianapolis, IN 46202-1403

Mailing address

1725 N Meridian St
Indianapolis, IN 46202-1403
Phone (317) 396-2679

Other names 1

  • Morgan R Dall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210330001346 IN Practitioner - Physician Assistant 3678980182 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Directed Rehabilitation ServicesGroup PAC ID 2860819372, 11 clinicians
Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

10312 Allisonville Rd
Fishers, IN 46038-2635
Phone (708) 768-1507

1725 N Meridian St
Indianapolis, IN 46202-1403
Phone (317) 396-2679

4925 S Scatterfield Rd
Anderson, IN 46013-2911
Phone (765) 442-0402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest M PLLC Physician Assistant CurrentSince Mar 1, 2026 Accepting new patients
Cleanslate Medical Group of Pennsylvania LLC Past Accepting new patients

Locations

155 E Burks Dr
Bloomington, IN 47401
Phone (812) 322-4437

Organizations & group practices 5

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": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1124620455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021403",
            "telephone_number": "317-396-2679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 N MERIDIAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462021403",
            "telephone_number": "317-396-2679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCKBEE",
        "first_name": "MORGAN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003224A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MORGAN",
            "last_name": "DALL",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.