Individual provider Active NPI

Kameron Tyler Morris

  • Behavior Analyst
  • Jacksonville, NC
National Provider Identifier
1457122707
Registry record updated Jan 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
304 Wellington PL
Jacksonville, NC 28546-8341
Phone
(910) 333-8050
NPI assigned
Jan 15, 2024
Last updated
Jan 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

304 Wellington PL
Jacksonville, NC 28546-8341

Mailing address

1926 Greenstone CT
Midway Park, NC 28544-1628
Phone (910) 915-6767

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

Practice roles

OrganizationSpecialtyStatusNew patients
Successful Child ABA Therapy, LLC Behavior Analyst PastSince Jan 21, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705276800000",
    "number": "1457122707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1926 GREENSTONE CT",
            "city": "MIDWAY PARK",
            "state": "NC",
            "postal_code": "285441628",
            "telephone_number": "910-915-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 WELLINGTON PL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285468341",
            "telephone_number": "910-333-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "KAMERON",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-15",
        "last_updated": "2024-01-15",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; 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.