Individual provider Active NPI

Diane L Morris, M.D.

  • Internal Medicine Physician
  • Waterford, MI
National Provider Identifier
1164446464
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301056437 Issued in MI
Practice address
1255 N. Oakland
Waterford, MI 48327-2100
Phone
(248) 406-0090
Fax
(248) 406-0107
NPI assigned
Jul 27, 2006
Last updated
Mar 31, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301056437 MI Primary

Addresses

Primary practice location

1255 N. Oakland
Waterford, MI 48327-2100

Mailing address

1255 N Oakland Blvd
Waterford, MI 48327-1545
Phone (248) 406-0090

Other identifiers 2

IdentifierTypeStateIssuer
F37128015OtherMIMEDICARE ID
3487106MedicaidMI

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303000901 MI Practitioner - Internal Medicine 9335284272 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301056437MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Programs Inc. CurrentSince Mar 24, 2016 Accepting new patients
Community Programs, Inc. CurrentSince Mar 24, 2016 Accepting new patients
Community Programs, Inc. PastSince Mar 1, 2020 Accepting new patients

Locations

1289 S Linden Rd
Ste D
Flint, MI 48532
Phone (248) 599-8999

G3500 Flushing Rd
Ste 200
Flint, MI 48504
Phone (248) 599-8999

91 N Saginaw St
Ste G100
Pontiac, MI 48342
Phone (248) 599-8999

33200 Dequindre Rd
Ste 100
Sterling Heights, MI 48310
Phone (583) 354-1489

1255 N Oakland Blvd
Waterford, MI 48327
Phone (248) 406-0090

1435 N Oakland Blvd
Waterford, MI 48327
Phone (248) 406-0090

269 Summit Dr
Waterford, MI 48328
Phone (248) 599-8999

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1164446464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 N OAKLAND BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271545",
            "telephone_number": "248-406-0090",
            "fax_number": "248-406-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 N. OAKLAND",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483272100",
            "telephone_number": "248-406-0090",
            "fax_number": "248-406-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "DIANE",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301056437",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "F37128015",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3487106",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.