Individual provider Active NPI

Theodore M Morgan Sr., MD

  • Emergency Medicine Physician
  • Pike Road, AL
National Provider Identifier
1295777126
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00012524 Issued in AL
Practice address
155 Glynlakes Dr
Pike Road, AL 36064-1767
Phone
(334) 283-6541
NPI assigned
Jun 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00012524 AL Primary
Family Medicine Physician 207Q00000X 12524 AL

Addresses

Primary practice location

155 Glynlakes Dr
Pike Road, AL 36064-1767

Mailing address

155 Glynlakes Dr
Pike Road, AL 36064-1767
Phone (334) 281-6205

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00012524ALMDEmergency Medicine Physician
12524ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital Inc Current Accepting new patients
Clanton Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Jackson Montgomery Emergency Physcians, LLC Emergency Medicine Past Accepting new patients
Alteon Health Alabama, LLC Emergency Medicine Past Accepting new patients
United Emergency Services, Inc. Emergency Medicine Past Accepting new patients

Locations

805 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-6541

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1295777126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 GLYNLAKES DR",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360641767",
            "telephone_number": "334-281-6205",
            "fax_number": "334-281-6208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLYNLAKES DR",
            "city": "PIKE ROAD",
            "state": "AL",
            "postal_code": "360641767",
            "telephone_number": "334-283-6541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "THEODORE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "00012524",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "12524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pike Road, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.