Individual provider Active NPI

Jeremy Wade Morris, RN

  • Adult Health Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1437437977
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APO6644 Issued in LA
Practice address
1717 Oak Park Blvd FL 3
Lake Charles, LA 70601-8990
Phone
(337) 494-4900
NPI assigned
Aug 2, 2011
Last updated
Sep 1, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APO6644 LA Primary
Registered Nurse 163W00000X RN114079 LA

Addresses

Primary practice location

1717 Oak Park Blvd FL 3
Lake Charles, LA 70601-8990

Mailing address

PO Box 122165
Dept 2165
Dallas, TX 75312-2165
Phone (337) 494-4900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000911 LA Practitioner - Nurse Practitioner 0547428682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Physical Therapy Services of West Louisiana IncGroup PAC ID 0446388763, 92 clinicians

Practice addresses (Care Compare)

1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236

301 W Fertitta Blvd
Suite 4
Leesville, LA 71446-4665
Phone (337) 238-9931

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
71.77 of 100Reported as individual
Quality
32.18
Promoting interoperability
99
Improvement activities
40
Cost
74.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN114079LAMDRegistered Nurse
APO6644LAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopaedics and Spine LLC CurrentSince Mar 2, 2020 Accepting new patients
Center for Orthopaedics and Spine LLC CurrentSince Mar 2, 2020 Accepting new patients

Locations

1355 Sam Houston Jones Pkwy
Ste 340
Lake Charles, LA 70611
Phone (337) 721-7236

1747 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 721-7236

Organizations & group practices 3

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 4

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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472688000000",
    "number": "1437437977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122165",
            "address_2": "DEPT 2165",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122165",
            "telephone_number": "337-494-4900",
            "fax_number": "337-494-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD FL 3",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018990",
            "telephone_number": "337-494-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JEREMY",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-02",
        "last_updated": "2016-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "APO6644",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN114079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.