Active NPI
John Kenneth Mori, M.D.
- Sleep Medicine (Psychiatry & Neurology) Physician
- Boulder, CO
National Provider Identifier
1497767172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sleep Medicine (Psychiatry & Neurology) Physician
- License
- 42465
- Practice address
- 4895 Riverbend Rd
Suite a
Boulder, CO 80301-2640 - Phone
- (720) 279-9098
- Fax
- (720) 540-4250
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sleep Medicine (Psychiatry & Neurology) Physician | 2084S0012X | 42465 | TN | Primary |
Addresses
Primary practice location
4895 Riverbend Rd
Suite a
Boulder, CO 80301-2640
Mailing address
3712 Woodmont LN Unit B
Nashville, TN 37215-1714
Phone (615) 509-0584
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K167432 | Other | KY | MEDICARE |
| 7100048410 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep Centers of Middle Tennessee LLC | Sleep Medicine | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CEBDAA
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.
-
- Sleep Medicine (Internal Medicine) Physician
- Murfreesboro, TN
- NPI 1003914201
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721779200000",
"number": "1497767172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3712 WOODMONT LN UNIT B",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372151714",
"telephone_number": "615-509-0584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4895 RIVERBEND RD",
"address_2": "SUITE A",
"city": "BOULDER",
"state": "CO",
"postal_code": "803012640",
"telephone_number": "720-279-9098",
"fax_number": "720-540-4250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORI",
"first_name": "JOHN",
"middle_name": "KENNETH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2024-07-24",
"certification_date": "2024-07-24",
"status": "A"
},
"taxonomies": [
{
"code": "2084S0012X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Sleep Medicine",
"state": "TN",
"license": "42465",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "K167432",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100048410",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 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.