Individual provider Active NPI

Lerraughn Marcellus Morgan, DO

  • Pediatric Cardiology Physician
  • Madera, CA
National Provider Identifier
1760724975
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
20A17103 Issued in CA
Practice address
9300 Valley Childrens PL # Fe10
Madera, CA 93636-8761
Phone
(559) 353-5941
Fax
(559) 353-5945
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Cardiology Physician 2080P0202X 20A17103 CA Primary

Addresses

Primary practice location

9300 Valley Childrens PL # Fe10
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL # Fe10
Madera, CA 93636-8761
Phone (559) 353-5941

Other practice location 1

571 S Floyd St
Suite 412
Louisville, KY 40202-3818
Phone (502) 629-8828

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715001985 CA Practitioner - Other (Physician) 2163715780 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A17103CAMDPediatric Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Children'S Medical Group CurrentSince Jul 22, 2019 Accepting new patients
Hennepin Healthcare System, Inc Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients
Reedley Community Hospital Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

300 S Leon S. Peters Blvd
Fowler, CA 93625
Phone (559) 834-1614

215 N Fresno St
Ste 370B
Fresno, CA 93701

215 N Fresno St
Ste 370
Fresno, CA 93701
Phone (559) 459-2327

9300 Valley Childrens Pl
#10
Madera, CA 93636
Phone (559) 353-5941

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

Interoperability endpoints

  • Direct secure messaging: lmorgan62376@valleychildrens-prd.direct-ci.com

Organizations & group practices 5

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": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1760724975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # FE10",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5941",
            "fax_number": "559-353-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL # FE10",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5941",
            "fax_number": "559-353-5945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "571 S Floyd St",
            "address_2": "Suite 412",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402023818",
            "country_code": "US",
            "telephone_number": "502-629-8828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "LERRAUGHN",
        "middle_name": "MARCELLUS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "20A17103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

Verify at the official NPI Registry.