Individual provider Active NPI

Morgan Dudley, M.D.

  • Internal Medicine Physician
  • East Lansing, MI
National Provider Identifier
1366892325
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301110012 Issued in MI
Practice address
804 Service Rd RM A225
East Lansing, MI 48824-7015
Phone
(517) 353-4941
Fax
(517) 432-3145
NPI assigned
Jun 20, 2016
Last updated
Jun 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301110012 MI Primary

Addresses

Primary practice location

804 Service Rd RM A225
East Lansing, MI 48824-7015

Mailing address

788 Service Rd RM B301
East Lansing, MI 48824-7013
Phone (517) 355-5100

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211022000739 MI Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 3678961703

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301110012MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan State University Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mdudley1125692@direct.hfhs.org

Organizations & group practices 1

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": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1366892325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 SERVICE RD RM B301",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247013",
            "telephone_number": "517-355-5100",
            "fax_number": "517-432-2759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD RM A225",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-4941",
            "fax_number": "517-432-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "MORGAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301110012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.