NPIMap

Individual provider Active NPI

Peter Morrissey

  • Adult Companion
  • Gainesville, GA
National Provider Identifier
1750920138
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult CompanionTaxonomy code 372600000X
License
069-R-0680 Issued in GA
Practice address
731 Queen City Pkwy Ste 102
Gainesville, GA 30501-4357
Phone
(770) 535-3007
NPI assigned
Jan 2, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Companion 372600000X 069-R-0680 GA Primary

Addresses

Primary practice location

731 Queen City Pkwy Ste 102
Gainesville, GA 30501-4357

Mailing address

731 Queen City Pkwy Ste 102
Gainesville, GA 30501-4357
Phone (770) 535-3007

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
069-R-0680GAMDAdult Companion

Practice roles

OrganizationSpecialtyStatusNew patients
Vita Holdings Inc Current Accepting new patients
Sand and Service LLC Current Accepting new patients
Am PM Assets, Inc. Current Accepting new patients
RW Convergence, Inc PastSince Jan 5, 2020 Accepting new patients

Organizations & group practices 4

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": "1577923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1750920138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 QUEEN CITY PKWY STE 102",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014357",
            "telephone_number": "770-535-3007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 QUEEN CITY PKWY STE 102",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305014357",
            "telephone_number": "770-535-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRISSEY",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "GA",
            "license": "069-R-0680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.