Individual provider Active NPI

Bobby J Morris Jr., R.PH.

  • Pharmacist
  • Monroe, LA
National Provider Identifier
1376830232
Registry record updated Jun 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PST.018512 Issued in LA
Practice address
4103 Pecanland Mall Dr
T-1469
Monroe, LA 71203-7009
Phone
(318) 388-3474
Fax
(318) 388-3474
NPI assigned
Jun 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PST.018512 LA Primary

Addresses

Primary practice location

4103 Pecanland Mall Dr
T-1469
Monroe, LA 71203-7009

Mailing address

4103 Pecanland Mall Dr
T-1469
Monroe, LA 71203-7009
Phone (318) 388-3474

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PST.018512LAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309305600000",
    "number": "1376830232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 PECANLAND MALL DR",
            "address_2": "T-1469",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712037009",
            "telephone_number": "318-388-3474",
            "fax_number": "318-388-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4103 PECANLAND MALL DR",
            "address_2": "T-1469",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712037009",
            "telephone_number": "318-388-3474",
            "fax_number": "318-388-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "BOBBY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-29",
        "last_updated": "2011-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST.018512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.