Active NPI
Jackson Morris
- Social Worker
- Rochester, NY
National Provider Identifier
1215440375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 091805
- Practice address
- 2300 East Ave
Rochester, NY 14610-2564 - Phone
- (585) 667-1367
- NPI assigned
- Nov 13, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 102105-1 | NY | |
| Social Worker | 104100000X | 091805 | NY | Primary |
Addresses
Primary practice location
2300 East Ave
Rochester, NY 14610-2564
Mailing address
1143 Rousseau Dr
Webster, NY 14580-4115
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
| License | State | Type | Specialty |
|---|---|---|---|
| 091805 | NY | MD | Social Worker |
| 102105-1 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1215440375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1143 ROUSSEAU DR",
"city": "WEBSTER",
"state": "NY",
"postal_code": "145804115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 EAST AVE",
"city": "ROCHESTER",
"state": "NY",
"postal_code": "146102564",
"telephone_number": "585-667-1367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "JACKSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-11-13",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "102105-1",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "091805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.