Active NPI
Jon B Morris, PAC
- Physician Assistant
- Pontiac, MI
National Provider Identifier
1538138151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601001916
- Practice address
- 44405 Woodward Ave
Attn Cardiothoracic Surgery
Pontiac, MI 48341-5023 - Phone
- (248) 858-6717
- Fax
- (248) 858-6274
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601001916 | MI | Primary |
Addresses
Primary practice location
44405 Woodward Ave
Attn Cardiothoracic Surgery
Pontiac, MI 48341-5023
Mailing address
44405 Woodward Ave
Attn Cardiothoracic Surgery
Pontiac, MI 48341-5023
Phone (248) 858-6717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00198482 | Other | MI | TRAVELERS |
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601001916 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1538138151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"address_2": "ATTN CARDIOTHORACIC SURGERY",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-6717",
"fax_number": "248-858-6274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44405 WOODWARD AVE",
"address_2": "ATTN CARDIOTHORACIC SURGERY",
"city": "PONTIAC",
"state": "MI",
"postal_code": "483415023",
"telephone_number": "248-858-6717",
"fax_number": "248-858-6274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "JON",
"middle_name": "B",
"credential": "PAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601001916",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAVELERS",
"identifier": "P00198482",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pontiac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.