Individual provider Active NPI

Owen Morris, DPM

  • Primary Podiatric Medicine Podiatrist
  • Philadelphia, PA
National Provider Identifier
1710405675
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
SC007232 Issued in PA
Practice address
1575 N 52ND St Ste S-3
Philadelphia, PA 19131-4736
Phone
(267) 930-4858
Fax
(267) 299-6270
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 25MD00354500 NJ
Primary Podiatric Medicine Podiatrist 213EP1101X SC007232 PA Primary

Addresses

Primary practice location

1575 N 52ND St Ste S-3
Philadelphia, PA 19131-4736

Mailing address

1575 N 52ND St Ste S-3
Philadelphia, PA 19131-4736
Phone (267) 930-4858

Other practice location 1

1000 Houghton Ave
Saginaw, MI 48602-5303
Phone (989) 583-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20220929002551 PA Practitioner - Podiatry 2062836927 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25MD00354500NJMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dedicated Pennsylvania Holding, LLC CurrentSince Nov 1, 2022 Accepting new patients
Dedicated Pennsylvania Holding, LLC Current Accepting new patients
Dedicated Pennsylvania Holding, LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

1575 N 52nd St
Ste S3
Philadelphia, PA 19131
Phone (267) 930-4858

Organizations & group practices 3

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1710405675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 N 52ND ST STE S-3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191314736",
            "telephone_number": "267-930-4858",
            "fax_number": "267-299-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 N 52ND ST STE S-3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191314736",
            "telephone_number": "267-930-4858",
            "fax_number": "267-299-6270"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Houghton Ave",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486025303",
            "country_code": "US",
            "telephone_number": "989-583-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "OWEN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "25MD00354500",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "PA",
            "license": "SC007232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.