Individual provider Active NPI

Jacob Brannon Morris, MD

  • Family Medicine Physician
  • Pearl, MS
National Provider Identifier
1386209500
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30249 Issued in MS
Practice address
101 Millstone Dr
Pearl, MS 39208-8956
Phone
(769) 428-7057
NPI assigned
May 2, 2019
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MS
Family Medicine Physician 207Q00000X 30249 MS Primary

Addresses

Primary practice location

101 Millstone Dr
Pearl, MS 39208-8956

Mailing address

400 Burnham Rd
Brandon, MS 39042-2550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20220906001892 MS Practitioner - Family Practice 7012248826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Mississippi School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris Medical Services PAGroup PAC ID 7618351982, 2 clinicians

Practice addresses (Care Compare)

101 Millstone Dr
Pearl, MS 39208-8956
Phone (601) 806-2158

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
30249MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Medical Services PA Family Medicine CurrentSince Oct 1, 2022 Accepting new patients

Locations

101 Millstone Dr
Pearl, MS 39208
Phone (601) 806-2158

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1386209500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BURNHAM RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MILLSTONE DR",
            "city": "PEARL",
            "state": "MS",
            "postal_code": "392088956",
            "telephone_number": "769-428-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JACOB",
        "middle_name": "BRANNON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "30249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl, MS

Sources for this page

Verify at the official NPI Registry.