Individual provider Active NPI

Sequita M Morris, MD

  • Family Medicine Physician
  • Fenton, MO
National Provider Identifier
1467414268
Registry record updated Oct 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2010039469 Issued in MO
Practice address
774 Gravois Bluffs Blvd
Ste B
Fenton, MO 63026-7758
Phone
(636) 685-7734
NPI assigned
Apr 5, 2006
Last updated
Oct 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2010039469 MO Primary

Addresses

Primary practice location

774 Gravois Bluffs Blvd
Ste B
Fenton, MO 63026-7758

Mailing address

774 Gravois Bluffs Blvd
Ste B
Fenton, MO 63026-7758
Phone (636) 685-7734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110119000266 MO Practitioner - General PracticePractitioner - Family Practice 5890754022 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
State of Missouri CurrentSince Sep 22, 2022 Accepting new patients
State of Missouri CurrentSince Sep 22, 2022 Accepting new patients
Regional Employee Assistance Program Inc Family Medicine Past Accepting new patients
Mineral Area Osteopathic Hospital Inc Family Medicine Past Accepting new patients
Physician Groups LC Family Medicine Past Accepting new patients
St. Lukes Orthopedics Woods Mill, LLC PastSince Apr 1, 2016 Accepting new patients
Physician Groups LC Past Accepting new patients

Locations

1010 W Columbia St
Farmington, MO 63640
Phone (573) 218-6792

Organizations & group practices 7

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1467414268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 GRAVOIS BLUFFS BLVD",
            "address_2": "STE B",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267758",
            "telephone_number": "636-685-7734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 GRAVOIS BLUFFS BLVD",
            "address_2": "STE B",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267758",
            "telephone_number": "636-685-7734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "SEQUITA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2010039469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MO

Sources for this page

Verify at the official NPI Registry.