Organization Active NPI

Dr Kristina Morris LLC

  • Optometrist
  • Bloomington, IN
National Provider Identifier
1174647846
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18002665B Issued in IN
Legal business name
DR KRISTINA MORRIS LLC
Practice address
4619 W Richland Plaza Dr
Bloomington, IN 47404-9776
Phone
(812) 332-3937
Fax
(812) 336-7697
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Authorized official

Name
Dr. Kristina Morris, OD
Title
Owner
Phone
(812) 332-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 18002665B IN Primary

Addresses

Primary practice location

4619 W Richland Plaza Dr
Bloomington, IN 47404-9776

Mailing address

4619 W Richland Plaza Dr
Bloomington, IN 47404-9776
Phone (812) 332-3937

Other identifiers 1

IdentifierTypeStateIssuer
200412960MedicaidIN

Other names 1

  • Dr Kristina Morris and Lithia Jimenez Former legal business name

National Provider Directory

National Provider Directory

Locations

4619 W Richland Plaza Dr
Bloomington, IN 47404
Phone (812) 332-3937

3510 W State Road 46
Bloomington, IN 47404
Phone (812) 332-3937

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1174647846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4619 W RICHLAND PLAZA DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474049776",
            "telephone_number": "812-332-3937",
            "fax_number": "812-336-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4619 W RICHLAND PLAZA DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474049776",
            "telephone_number": "812-332-3937",
            "fax_number": "812-336-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KRISTINA MORRIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-332-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002665B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200412960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Kristina Morris and Lithia Jimenez",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.