NPIMap

Individual provider Active NPI

Caroline Morris, PA

  • Physician Assistant
  • Beverly Hills, MI
National Provider Identifier
1174804488
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006115 Issued in MI
Practice address
30508 Georgetown Dr
Beverly Hills, MI 48025-4731
Phone
(706) 296-9286
NPI assigned
Aug 31, 2011
Last updated
Aug 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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 5601006115 MI Primary

Addresses

Primary practice location

30508 Georgetown Dr
Beverly Hills, MI 48025-4731

Mailing address

30508 Georgetown Dr
Beverly Hills, MI 48025-4731
Phone (706) 296-9286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120305000621 MI Practitioner - Physician Assistant 4183883531 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daisy Mae Family Medicine PLLCGroup PAC ID 0749672848, 2 clinicians

Practice addresses (Care Compare)

20400 W Warren Ave
Detroit, MI 48228-3242
Phone (313) 271-0500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Daisy Mae Family Medicine PLLC CurrentSince Dec 20, 2025 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients

Locations

20400 W Warren Ave
Detroit, MI 48228
Phone (313) 271-0500

Interoperability endpoints

  • Direct secure messaging: cmorris779728@direct.hfhs.org

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

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1174804488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30508 GEORGETOWN DR",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480254731",
            "telephone_number": "706-296-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30508 GEORGETOWN DR",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480254731",
            "telephone_number": "706-296-9286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "CAROLINE",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, MI

Sources for this page

Verify at the official NPI Registry.