Active NPI
Michael Clark Morris
- Pharmacist
- Tullahoma, TN
National Provider Identifier
1710240932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28988
- Practice address
- 132 Will Hickerson Rd
Tullahoma, TN 37388-6779 - Phone
- (931) 455-7065
- NPI assigned
- Jun 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28988 | TN | Primary |
| Pharmacist | 183500000X | 9999 | KY |
Addresses
Primary practice location
132 Will Hickerson Rd
Tullahoma, TN 37388-6779
Mailing address
132 Will Hickerson Rd
Tullahoma, TN 37388-6779
Phone (931) 455-7065
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9999 | Other | KY | PHARMACY LICENSE |
| 28988 | Other | TN | PHARMACY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9999 | KY | MD | Pharmacist |
| 28988 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1710240932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 WILL HICKERSON RD",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373886779",
"telephone_number": "931-455-7065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 WILL HICKERSON RD",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373886779",
"telephone_number": "931-455-7065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRIS",
"first_name": "MICHAEL",
"middle_name": "CLARK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-21",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "28988",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "KY",
"license": "9999",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "9999",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACY LICENSE",
"identifier": "28988",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tullahoma, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.