Individual provider Active NPI

Cory Morrison, P.A.-C

  • Surgical Physician Assistant
  • Hawthorne, CA
National Provider Identifier
1750682803
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
14475 Issued in CA
Practice address
5413 W 123Rd St
Hawthorne, CA 90250-3422
Phone
(310) 725-9547
NPI assigned
Nov 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 14475 CA Primary

Addresses

Primary practice location

5413 W 123Rd St
Hawthorne, CA 90250-3422

Mailing address

5413 W 123Rd St
Hawthorne, CA 90250-3422

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912002791 CA Practitioner - Physician Assistant 9830639160 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Group practices
Goodlife Physical Medicine CorpGroup PAC ID 0446542922, 11 clinicians

Practice addresses (Care Compare)

1300 S Pacific Coast Hwy
Suite 201
Redondo Beach, CA 90277-5003
Phone (310) 543-7779

2365 Seal Beach Blvd
Suite 101
Seal Beach, CA 90740-5622
Phone (310) 543-7779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
14475CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Goodlife Physical Medicine Corp CurrentSince Jun 9, 2024 Accepting new patients

Locations

2218 E Maple Ave
El Segundo, CA 90245
Phone (310) 543-7779

1300 S Pacific Coast Hwy
Ste 201
Redondo Beach, CA 90277
Phone (310) 543-7779

2365 Seal Beach Blvd
Ste 101
Seal Beach, CA 90740
Phone (310) 543-7779

1231 Cabrillo Ave
#203
Torrance, CA 90501
Phone 3105437779140

Interoperability endpoints

  • Direct secure messaging: cory.morrison.1@22164.direct.athenahealth.com

Organizations & group practices 2

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": "1288915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288915200000",
    "number": "1750682803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5413 W 123RD ST",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5413 W 123RD ST",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902503422",
            "telephone_number": "310-725-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISON",
        "first_name": "CORY",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-05",
        "last_updated": "2010-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "14475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, CA

Sources for this page

Verify at the official NPI Registry.