Individual provider Active NPI

Patrick R Morris, D.D.S., M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Louis, MO
National Provider Identifier
1316937634
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
015607 Issued in MO
Practice address
11710 Old Ballas Rd Ste 208
Saint Louis, MO 63141-7076
Phone
(314) 866-6725
Fax
(314) 998-6725
NPI assigned
Oct 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2000163887 MO
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 015607 MO Primary

Addresses

Primary practice location

11710 Old Ballas Rd Ste 208
Saint Louis, MO 63141-7076

Mailing address

11710 Old Ballas Rd Ste 208
Saint Louis, MO 63141-7076
Phone (314) 866-6725

Other practice location 1

10200 West Main Street
Belleville, IL 62223-1408
Phone (618) 400-6725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100922000940 MO Practitioner - Maxillofacial Surgery 6901922384 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2000163887MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oral Facial Surgery Institute of Illinois P C Current Accepting new patients
Vision Surgical Arts, LLC CurrentSince Jan 15, 2021 Accepting new patients
Clarkson Oral Surgery Oral and Maxillofacial Surgery Past Accepting new patients

Locations

10200 W Main St
Belleville, IL 62223
Phone (618) 397-2464

2997 Clarkson Rd
Ste 120
Chesterfield, MO 63017
Phone (636) 400-6725

60 E North St
Eureka, MO 63025
Phone (314) 251-6725

621 S New Ballas Rd
Ste 1
Saint Louis, MO 63141
Phone (314) 251-6725

621 S New Ballas Rd
Ste 16A
Saint Louis, MO 63141
Phone (314) 251-6725

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

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": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1316937634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11710 OLD BALLAS RD STE 208",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-866-6725",
            "fax_number": "314-998-6725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 OLD BALLAS RD STE 208",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631417076",
            "telephone_number": "314-866-6725",
            "fax_number": "314-998-6725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10200 West Main Street",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622231408",
            "country_code": "US",
            "telephone_number": "618-400-6725",
            "fax_number": "618-500-6725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "PATRICK",
        "middle_name": "R",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2000163887",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "015607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.