Individual provider Active NPI

Jason E Morris, D.P.M.

  • Podiatrist
  • Atlanta, GA
National Provider Identifier
1306856018
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000990 Issued in GA
Practice address
5445 Meridian Marks Rd Ste 390
Atlanta, GA 30342-4755
Phone
(404) 237-3668
Fax
(404) 237-9562
NPI assigned
Aug 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 000990 GA Primary

Addresses

Primary practice location

5445 Meridian Marks Rd Ste 390
Atlanta, GA 30342-4755

Mailing address

900 Circle 75 Pkwy SE Ste 900
Atlanta, GA 30339-3084
Phone (678) 426-2171

Other practice location 1

1711 Mount Vernon Rd
Dunwoody, GA 30338-4242
Phone (770) 394-7312

Other identifiers 3

IdentifierTypeStateIssuer
769029729AMedicaidGA
202458594OtherGATAX ID
800578OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140812002058 GA Practitioner - Podiatry 6507833001 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Anesthesia, LLC CurrentSince Oct 16, 2014 Accepting new patients
Georgia Ambulatory Surgery Center LLC Current Accepting new patients
J3P LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

3867 Holcomb Bridge Rd
Ste 300
Peachtree Corners, GA 30092
Phone (678) 694-1234

2175 North Rd
Snellville, GA 30078
Phone (770) 284-9171

Interoperability endpoints

  • Direct secure messaging: jfootdoc@ufalc-ga.direct.office.nextgen.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1306856018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE STE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393084",
            "telephone_number": "678-426-2171",
            "fax_number": "404-446-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD STE 390",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424755",
            "telephone_number": "404-237-3668",
            "fax_number": "404-237-9562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1711 Mount Vernon Rd",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "303384242",
            "country_code": "US",
            "telephone_number": "770-394-7312",
            "fax_number": "404-481-4434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JASON",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "769029729A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "202458594",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "800578",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.