Individual provider Active NPI

Colleen Bridget Morrison, M.D.

  • Pediatrics Physician
  • South Bend, IN
National Provider Identifier
1437306552
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01068867A Issued in IN
Practice address
1815 E Ireland Rd
South Bend, IN 46614-2845
Phone
(574) 647-1700
NPI assigned
Aug 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01068867A IN Primary
Pediatric Hematology & Oncology Physician 2080P0207X 01068867A IN

Addresses

Primary practice location

1815 E Ireland Rd
South Bend, IN 46614-2845

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

6913 N Main St Ste 200
Granger, IN 46530-8039
Phone (574) 647-4540

Other identifiers 1

IdentifierTypeStateIssuer
201001530MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmorrison@mybeacon.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150218002204 IN Practitioner - Pediatric Medicine 6901121730 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Medical Group, Inc. Pediatric Hematology-Oncology CurrentSince Apr 1, 2023 Accepting new patients
Beacon Medical Group Inc CurrentSince Jan 3, 2015 Accepting new patients
Beacon Medical Group, Inc. Current Accepting new patients
Beacon Medical Group, Inc. CurrentSince Jan 3, 2015 Accepting new patients
Beacon Medical Group, Inc. PastSince Apr 1, 2021 Accepting new patients

Locations

6913 N Main St
Ste 200
Granger, IN 46530
Phone (574) 647-4540

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

100 Navarre Pl
Ste 5550
South Bend, IN 46601
Phone (574) 234-5123

710 N Niles Ave
South Bend, IN 46617
Phone (574) 647-1610

615 N Michigan St
#6E
South Bend, IN 46601
Phone (574) 647-6892

1815 E Ireland Rd
South Bend, IN 46614
Phone (574) 647-1700

615 N Michigan St
Fl 4
South Bend, IN 46601
Phone (574) 647-6892

Organizations & group practices 5

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": "1219190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1437306552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 E IRELAND RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142845",
            "telephone_number": "574-647-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6913 N Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-4540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "COLLEEN",
        "middle_name": "BRIDGET",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-20",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01068867A",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "IN",
            "license": "01068867A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201001530",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmorrison@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "615 N Michigan St Fl 4",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466011033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.