Individual provider Active NPI

Deidra Cantrell Morrison, DPT

  • Physical Therapist
  • Orlando, FL
National Provider Identifier
1679742910
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT31472 Issued in FL
Practice address
6965 Piazza Grande Ave #210
210-4
Orlando, FL 32835
Phone
(804) 931-6864
Fax
(240) 483-4175
NPI assigned
Feb 20, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT31472 FL Primary

Addresses

Primary practice location

6965 Piazza Grande Ave #210
210-4
Orlando, FL 32835

Mailing address

12030 Silverlake Park Dr
Windermere, FL 34786-9480
Phone (804) 931-6864

Other identifiers 2

IdentifierTypeStateIssuer
3810025110MedicaidWV
0089767MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180418000377 FL Practitioner - Physical Therapist in Private Practice 4688819089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6965 Piazza Grande Ave
Suite 215
Orlando, FL 32835-8780
Phone (407) 906-6007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT31472FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Deis Physical Therapy Centre Inc Physical Therapist CurrentSince Feb 4, 2018 Accepting new patients

Locations

6965 Piazza Grande Ave
Ste 215
Orlando, FL 32835
Phone (407) 906-6007

Organizations & group practices 1

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": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1679742910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12030 SILVERLAKE PARK DR",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347869480",
            "telephone_number": "804-931-6864",
            "fax_number": "240-483-4175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6965 PIAZZA GRANDE AVE #210",
            "address_2": "210-4",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32835",
            "telephone_number": "804-931-6864",
            "fax_number": "240-483-4175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "DEIDRA",
        "middle_name": "CANTRELL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31472",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810025110",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0089767",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.