Individual provider Active NPI

Kerri Morris, PT

  • Pediatric Physical Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1740384254
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT35202 Issued in FL
Practice address
24 Hollywood Blvd SW Ste 7
Fort Walton Beach, FL 32548-4893
Phone
(850) 226-7411
Fax
(850) 226-7496
NPI assigned
Sep 13, 2006
Last updated
Mar 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT1942 AR
Pediatric Physical Therapist 2251P0200X PT35202 FL Primary

Addresses

Primary practice location

24 Hollywood Blvd SW Ste 7
Fort Walton Beach, FL 32548-4893

Mailing address

24 Hollywood Blvd SW Ste 7
Fort Walton Beach, FL 32548-4893
Phone (850) 226-7411

Other identifiers 1

IdentifierTypeStateIssuer
792357MedicaidFL

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

LicenseStateTypeSpecialty
PT1942ARMDSpecialist
PT35202FLMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Treehouse Therapies, LLC Pediatrics CurrentSince Aug 28, 2021 Accepting new patients
Building Bridges Developmental and Community Services Past Accepting new patients
Treehouse Therapies, LLC PastSince Jun 1, 2020 Accepting new patients

Locations

24 Hollywood Blvd SW
Ste 7
Fort Walton Beach, FL 32548
Phone (850) 226-7411

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1740384254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HOLLYWOOD BLVD SW STE 7",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484893",
            "telephone_number": "850-226-7411",
            "fax_number": "850-226-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HOLLYWOOD BLVD SW STE 7",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484893",
            "telephone_number": "850-226-7411",
            "fax_number": "850-226-7496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "KERRI",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-03-08",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "PT1942",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "FL",
            "license": "PT35202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "792357",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.