Individual provider Active NPI

Lydell Bancroft Morrison

  • Pharmacist
  • Port St Lucie, FL
National Provider Identifier
1184109670
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS43773 Issued in FL
Practice address
8701 S US Highway 1
Port St Lucie, FL 34952-3333
Phone
(772) 301-1095
Fax
(772) 333-2728
NPI assigned
Oct 1, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS43773 FL Primary

Addresses

Primary practice location

8701 S US Highway 1
Port St Lucie, FL 34952-3333

Mailing address

8701 S US Highway 1
Port St Lucie, FL 34952-3333
Phone (772) 301-1095

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
PS43773FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Pills Potions & Lotions CurrentSince May 24, 2020 Accepting new patients
Pills Potions & Lotions Current Accepting new patients

Locations

8701 S US Highway 1
Port St Lucie, FL 34952
Phone (772) 301-1095

Organizations & group practices 2

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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1184109670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523333",
            "telephone_number": "772-301-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 S US HIGHWAY 1",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349523333",
            "telephone_number": "772-301-1095",
            "fax_number": "772-333-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "LYDELL",
        "middle_name": "BANCROFT",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS43773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.