Individual provider Active NPI

Kevin Wilson Morrill, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Schenectady, NY
National Provider Identifier
1639201817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
044618 Issued in NY
Practice address
2141 Eastern Pkwy
Schenectady, NY 12309-6347
Phone
(518) 372-2859
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 044618 NY Primary

Addresses

Primary practice location

2141 Eastern Pkwy
Schenectady, NY 12309-6347

Mailing address

2141 Eastern Pkwy
Schenectady, NY 12309-6347
Phone (518) 372-2859

Other identifiers 1

IdentifierTypeStateIssuer
01471952MedicaidNY

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639201817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 EASTERN PKWY",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123096347",
            "telephone_number": "518-372-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 EASTERN PKWY",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123096347",
            "telephone_number": "518-372-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRILL",
        "first_name": "KEVIN",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "044618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01471952",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.