Active NPI
Jerry Ben Morris, B.S.
- Mental Illness Community Based Residential Treatment Facility
- Fort Worth, TX
National Provider Identifier
1295922185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Practice address
- 1333 E Richmond Ave
Fort Worth, TX 76104-6116 - Phone
- (817) 926-7041
- Fax
- (817) 926-7461
- NPI assigned
- Sep 25, 2007
- 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 |
|---|---|---|---|---|
| Mental Illness Community Based Residential Treatment Facility | 320800000X | TX | Primary |
Addresses
Primary practice location
1333 E Richmond Ave
Fort Worth, TX 76104-6116
Mailing address
6901 Rebel Rd
Forest Hill, TX 76140-1815
Phone (817) 293-7347
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
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75-2795767 | TX | MD | Mental Illness Community Based Residential Treatment Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194912000000",
"number": "1295922185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6901 REBEL RD",
"city": "FOREST HILL",
"state": "TX",
"postal_code": "761401815",
"telephone_number": "817-293-7347",
"fax_number": "817-926-7461"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1333 E RICHMOND AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761046116",
"telephone_number": "817-926-7041",
"fax_number": "817-926-7461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "JERRY",
"middle_name": "BEN",
"name_prefix": "Mr.",
"credential": "B.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-25",
"last_updated": "2007-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "TX",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 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.