Individual provider Active NPI

W. Kenneth Morgan Jr.

  • Endodontics
  • Greensboro, NC
National Provider Identifier
1700843406
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
5452 Issued in NC
Practice address
1602 Benjamin Pkwy
Greensboro, NC 27408-2015
Phone
(336) 288-0010
Fax
(336) 282-5754
NPI assigned
Apr 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 5452 NC Primary

Addresses

Primary practice location

1602 Benjamin Pkwy
Greensboro, NC 27408-2015

Mailing address

1602 Benjamin Pkwy
Greensboro, NC 27408-2015
Phone (336) 288-0010

Other identifiers 1

IdentifierTypeStateIssuer
8996186MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140617001767 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779707526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5452NCMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1700843406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 BENJAMIN PKWY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082015",
            "telephone_number": "336-288-0010",
            "fax_number": "336-282-5754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 BENJAMIN PKWY",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274082015",
            "telephone_number": "336-288-0010",
            "fax_number": "336-282-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "W.",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "5452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8996186",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.