Individual provider Active NPI

Jonathan Wesley Morris, D.C.

  • Chiropractor
  • Crystal, MN
National Provider Identifier
1609140318
Registry record updated Feb 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5610 Issued in MN
Practice address
5640 W Broadway Ave
Crystal, MN 55428-3556
Phone
(763) 537-8070
Fax
(763) 537-9513
NPI assigned
Feb 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5610 MN Primary

Addresses

Primary practice location

5640 W Broadway Ave
Crystal, MN 55428-3556

Mailing address

5640 W Broadway Ave
Crystal, MN 55428-3556
Phone (763) 537-8070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120405000541 MN Practitioner - Chiropractic 6406017144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12805 Hwy 55
Suite 311
Plymouth, MN 55441-3865
Phone (763) 205-2191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5610MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bass Lake Chiropractic Clinic, P.a. Chiropractor CurrentSince Feb 29, 2012 Accepting new patients
Balanced Chiropractic LLC Chiropractor CurrentSince Feb 24, 2020 Accepting new patients

Locations

5640 W Broadway Ave
Minneapolis, MN 55428
Phone (763) 537-3655

4900 Highway 169 N
Ste 324
New Hope, MN 55428
Phone (763) 537-8070

12805 Highway 55
Ste 311
Plymouth, MN 55441
Phone (763) 205-2191

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330300800000",
    "number": "1609140318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283556",
            "telephone_number": "763-537-8070",
            "fax_number": "763-537-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283556",
            "telephone_number": "763-537-8070",
            "fax_number": "763-537-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "JONATHAN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-27",
        "last_updated": "2012-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.