Individual provider Active NPI

Andra Morris

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1316636731
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209.030096 Issued in IL
Practice address
1701 W Superior St
Chicago, IL 60622-5646
Phone
(312) 666-3494
NPI assigned
May 2, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209.030096 IL Primary

Addresses

Primary practice location

1701 W Superior St
Chicago, IL 60622-5646

Mailing address

1701 W Superior St
Chicago, IL 60622-5646
Phone (312) 666-3494

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918001532 IL Practitioner - Nurse Practitioner 0648711671 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.030096ILMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erie Family Health Center Inc CurrentSince Sep 9, 2024 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Sep 9, 2024 Accepting new patients

Locations

1701 W Superior St
#2
Chicago, IL 60622

1504 S Albany Ave
Chicago, IL 60623

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392

1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122

Interoperability endpoints

  • Direct secure messaging: amorris734239@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1316636731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225646",
            "telephone_number": "312-666-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225646",
            "telephone_number": "312-666-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "ANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-02",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209.030096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.