Active NPI
Jon Michael Morrissette, DPT
- Physical Therapist
- Charlotte, NC
National Provider Identifier
1376636431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10274
- Practice address
- 10965 Winds Crossing Dr Ste 300
Charlotte, NC 28273-2400 - Phone
- (704) 504-2194
- Fax
- (704) 504-2197
- NPI assigned
- Oct 2, 2006
- Last updated
- Aug 16, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10274 | NC | Primary |
Addresses
Primary practice location
10965 Winds Crossing Dr Ste 300
Charlotte, NC 28273-2400
Mailing address
PO Box 38600
Charlotte, NC 28278-1010
Phone (704) 504-2194
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7212120 | Medicaid | NC | |
| TH1743 | Medicaid | SC | |
| 195578 | Other | NC | MEDCOST |
| 205555042 | Other | NC | CORVEL |
| 068C2 | Other | NC | BCBS |
| 2509769 | Other | NC | MEDICARE NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10274 | NC | MD | Physical Therapist |
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.
-
- Physical Therapist
- Charlotte, NC
- NPI 1164508032
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692144000000",
"number": "1376636431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 38600",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282781010",
"telephone_number": "704-504-2194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10965 WINDS CROSSING DR STE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282732400",
"telephone_number": "704-504-2194",
"fax_number": "704-504-2197"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISSETTE",
"first_name": "JON",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2023-08-16",
"certification_date": "2023-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "10274",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7212120",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "TH1743",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "195578",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL",
"identifier": "205555042",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "068C2",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NC",
"identifier": "2509769",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.