Individual provider Active NPI

Keith Morley, LMSW

  • Clinical Social Worker
  • Holland, MI
National Provider Identifier
1336481118
Registry record updated Mar 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090300 Issued in MI
Practice address
12265 James St
Holland, MI 49424-8613
Phone
(616) 494-5698
Fax
(616) 393-5687
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801090300 MI Primary

Addresses

Primary practice location

12265 James St
Holland, MI 49424-8613

Mailing address

12265 James St
Holland, MI 49424-8613
Phone (616) 494-5698

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160505002129 MI Practitioner - Clinical Social Worker 7517266950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of OttawaGroup PAC ID 0042118036, 18 clinicians

Practice addresses (Care Compare)

12265 James St
Holland, MI 49424-8613
Phone (616) 393-5641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801090300MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ottawa County CMH Past Accepting new patients

Organizations & group practices 2

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": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363737600000",
    "number": "1336481118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12265 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248613",
            "telephone_number": "616-494-5698",
            "fax_number": "616-393-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12265 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248613",
            "telephone_number": "616-494-5698",
            "fax_number": "616-393-5687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORLEY",
        "first_name": "KEITH",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2013-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.