Individual provider Active NPI

Matthew Courtland Morgan, NP

  • Adult Health Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1477068351
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
PENDING Issued in MI
Practice address
5000 Browns Lake Rd
Jackson, MI 49203-5648
Phone
(517) 917-4886
NPI assigned
Dec 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 4704287611 MI
Adult Health Nurse Practitioner 363LA2200X PENDING MI Primary

Addresses

Primary practice location

5000 Browns Lake Rd
Jackson, MI 49203-5648

Mailing address

5000 Browns Lake Rd
Jackson, MI 49203-5648
Phone (517) 917-4886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20180605000258 MI Practitioner - Nurse Practitioner 9335404821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Cardiology PCGroup PAC ID 2567562291, 4 clinicians

Practice addresses (Care Compare)

1200 E Michigan Ave
Suite 725
Lansing, MI 48912-1832
Phone (517) 364-5599

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704287611MIMDEmergency Registered Nurse
PENDINGMIMDPhysician Assistant

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 and National Provider Directory roles.

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": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1477068351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 BROWNS LAKE RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035648",
            "telephone_number": "517-917-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 BROWNS LAKE RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492035648",
            "telephone_number": "517-917-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "MATTHEW",
        "middle_name": "COURTLAND",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "MI",
            "license": "4704287611",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.