Active NPI
Carl Glenmore Morrison Sr., M.D.
- General Practice Physician
- Palm Bay, FL
National Provider Identifier
1194147611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- ME64000
- Practice address
- 2125 Windbrook Drive
Palm Bay, FL 32909 - Phone
- (321) 676-8409
- NPI assigned
- Jan 17, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ME64000 | FL | Primary |
Addresses
Primary practice location
2125 Windbrook Drive
Palm Bay, FL 32909
Mailing address
P.O. Box 110982
Palm Bay, FL 32911
Phone (321) 676-8409
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME64000 | FL | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403481600000",
"number": "1194147611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 110982",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32911",
"telephone_number": "321-676-8409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2125 WINDBROOK DRIVE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "32909",
"telephone_number": "321-676-8409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISON",
"first_name": "CARL",
"middle_name": "GLENMORE",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-01-17",
"last_updated": "2014-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ME64000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Bay, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.