Individual provider Active NPI

Samuel Trent Morris, ATC/CSCS

  • Athletic Trainer
  • Hattiesburg, MS
National Provider Identifier
1629556907
Registry record updated Jul 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
AT00036 Issued in MS
Practice address
221 Pine LN
Hattiesburg, MS 39402-9213
Phone
(601) 270-5423
NPI assigned
Jul 30, 2018
Last updated
Jul 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT00036 MS Primary

Addresses

Primary practice location

221 Pine LN
Hattiesburg, MS 39402-9213

Mailing address

221 Pine LN
Hattiesburg, MS 39402-9213
Phone (601) 270-5423

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AT00036MSMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1629556907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 PINE LN",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394029213",
            "telephone_number": "601-270-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PINE LN",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394029213",
            "telephone_number": "601-270-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "SAMUEL",
        "middle_name": "TRENT",
        "credential": "ATC/CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-30",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MS",
            "license": "AT00036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.