Individual provider Active NPI

Kevin Donald Morse, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Portage, MI
National Provider Identifier
1164416194
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2901017686 Issued in MI
Practice address
3801 Glenkerry CT
Portage, MI 49024-0718
Phone
(269) 323-1527
NPI assigned
Sep 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2901017686 MI Primary

Addresses

Primary practice location

3801 Glenkerry CT
Portage, MI 49024-0718

Mailing address

3801 Glenkerry CT
Portage, MI 49024-0718
Phone (269) 323-1527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000456 MI Practitioner - Oral Surgery 1658550975 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901017686MIMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Kalamazoo Oral & Maxillofacial Surgery, P.C. Oral and Maxillofacial Surgery CurrentSince Jul 6, 2010 Accepting new patients

Locations

3801 Glenkerry Ct
Portage, MI 49024
Phone (269) 323-1527

3801 Glenkerry Ct
Ste 2
Portage, MI 49024
Phone (269) 323-1527

Interoperability endpoints

  • Direct secure messaging: kmorse3205295@direct.trinity-health.org

Organizations & group practices 1

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": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1164416194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240718",
            "telephone_number": "269-323-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 GLENKERRY CT",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490240718",
            "telephone_number": "269-323-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORSE",
        "first_name": "KEVIN",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2901017686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

Verify at the official NPI Registry.