Active NPI
Gerald W. Morris Jr., MD
- Family Medicine Physician
- South Bend, IN
National Provider Identifier
1508187352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11015587A
- Practice address
- 714 N Michigan St
South Bend, IN 46601-1035 - Phone
- (574) 647-7913
- Fax
- (574) 647-6819
- NPI assigned
- Jun 16, 2010
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11015587A | IN | Primary |
Addresses
Primary practice location
714 N Michigan St
South Bend, IN 46601-1035
Mailing address
3355 Douglas Rd
Suite 300
South Bend, IN 46635-1781
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gmorris17228@lakeland.midirect.net | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131106001034 | IN | Practitioner - Family Practice | 1355596602 | Reassigns benefits to 1 organization |
| I20140721000337 | TX | Practitioner - Family Practice | 1355596602 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11015587A | IN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pokagon Band of Potawatomi Indians | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group, Inc. | Family Medicine | Current | Accepting new patients |
| Beacon Medical Group Inc | Current | Accepting new patients | |
| Beacon Medical Group, Inc. | Past | Accepting new patients |
Locations
900 I St
Laporte, IN 46350
Phone (219) 324-1670
714 N Michigan St
South Bend, IN 46601
Phone (574) 647-7477
32652 Kno
Dowagiac, MI 49047
Phone (269) 782-4141
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Mishawaka, IN
- NPI 1033161617
Family Medicine, IN
-
- Federally Qualified Health Center (FQHC)
- Dowagiac, MI
- NPI 1497833271
TX
-
- Anesthesiology Physician
- Elkhart, IN
- NPI 1437803285
-
- Orthopaedic Surgery Physician
- South Bend, IN
- NPI 1831149525
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Watervliet, MI
- NPI 1700994845
Hospital
-
- General Acute Care Hospital
- Saint Joseph, MI
- NPI 1134220031
Hospital
-
- Home Health Agency
- Benton Harbor, MI
- NPI 1912094525
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Indiana University School of Medicine, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Pokagon Band of Potawatomi IndiansBeacon Medical Group Inc
Practice addresses (Care Compare)
32652 Kno
Dowagiac, MI 49047-9805
Phone (269) 782-4141
714 N Michigan St
Beacon Medical Group E Blair Warner
South Bend, IN 46601-1035
Phone (574) 647-7477
Hospital & facility affiliations
- Corewell Health Lakeland Hospitals St Joseph Hospital
- Lakeland Hospital, St Joseph
- Ascension Borgess Lee Hospital
- Corewell Health Watervliet Hospital
- Memorial Hospital of South Bend
- Bronson Methodist Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
| Removal or shaving of skin growth | 1-10 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1508187352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 DOUGLAS RD",
"address_2": "SUITE 300",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466351781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 N MICHIGAN ST",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011035",
"telephone_number": "574-647-7913",
"fax_number": "574-647-6819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "GERALD",
"middle_name": "W.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-16",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11015587A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gmorris17228@lakeland.midirect.net",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/PDF/TXT",
"address_1": "32652 Kno Drive",
"city": "Dowagiac",
"state": "MI",
"country_code": "US",
"postal_code": "49047",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.