Individual provider Active NPI

Theresa D Morris, LICENSED PROFESSIONA

  • Licensed Practical Nurse
  • Bristol, VA
National Provider Identifier
1134224827
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
0002064195 Issued in VA
Practice address
510 Cumberland St
Executive Plaza 4TH Floor
Bristol, VA 24201
Phone
(276) 645-4758
Fax
(276) 669-9093
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002064195 VA Primary

Addresses

Primary practice location

510 Cumberland St
Executive Plaza 4TH Floor
Bristol, VA 24201

Mailing address

510 Cumberland St
Executive Plaza 4TH Floor
Bristol, VA 24201
Phone (276) 645-4758

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

State licenses

LicenseStateTypeSpecialty
0002064195VAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134224827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CUMBERLAND ST",
            "address_2": "EXECUTIVE PLAZA 4TH FLOOR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "24201",
            "telephone_number": "276-645-4758",
            "fax_number": "276-669-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CUMBERLAND ST",
            "address_2": "EXECUTIVE PLAZA 4TH FLOOR",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "24201",
            "telephone_number": "276-645-4758",
            "fax_number": "276-669-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "THERESA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LICENSED PROFESSIONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VA",
            "license": "0002064195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.