Active NPI
Jerry Russell Morris, CSW
- Social Worker
- Ashland, KY
National Provider Identifier
1275684250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- KY-5104
- Practice address
- 10730 Midland Trail Drive
Ashland, KY 41102 - Phone
- (606) 928-0150
- Fax
- (606) 929-5965
- NPI assigned
- Jan 16, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | KY-5104 | KY | Primary |
Addresses
Primary practice location
10730 Midland Trail Drive
Ashland, KY 41102
Mailing address
2732 East Donna Drive
Ashland, KY 41102
Phone (606) 928-3520
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-5104 | KY | MD | Social Worker |
| 3368 | KY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275684250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2732 EAST DONNA DRIVE",
"city": "ASHLAND",
"state": "KY",
"postal_code": "41102",
"telephone_number": "606-928-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10730 MIDLAND TRAIL DRIVE",
"city": "ASHLAND",
"state": "KY",
"postal_code": "41102",
"telephone_number": "606-928-0150",
"fax_number": "606-929-5965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "JERRY",
"middle_name": "RUSSELL",
"credential": "CSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KY",
"license": "KY-5104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ashland, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.