Individual provider Active NPI

Jeffrey Morgan, PA-C

  • Physician Assistant
  • Alpharetta, GA
National Provider Identifier
1790145985
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008307 Issued in GA
Practice address
3400 Old Milton Pkwy Ste C290
Alpharetta, GA 30005-6491
Phone
(770) 667-4343
Fax
(770) 772-0937
NPI assigned
Mar 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 6336 AZ
Physician Assistant 363A00000X 008307 GA Primary

Addresses

Primary practice location

3400 Old Milton Pkwy Ste C290
Alpharetta, GA 30005-6491

Mailing address

3487 S Mercy Rd
Gilbert, AZ 85297-0432
Phone (480) 222-5601

Other identifiers 1

IdentifierTypeStateIssuer
120859MedicaidAZ

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)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Arrhythmia Consultants, PLC CurrentSince Mar 7, 2016 Accepting new patients
Northside Surgical Professional Services LLC Past Accepting new patients

Locations

3225 N Civic Center Plz
Ste 1
Scottsdale, AZ 85251
Phone (480) 447-3708

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": "1456790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1790145985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3487 S MERCY RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970432",
            "telephone_number": "480-222-5601",
            "fax_number": "480-222-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 OLD MILTON PKWY STE C290",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300056491",
            "telephone_number": "770-667-4343",
            "fax_number": "770-772-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN",
        "first_name": "JEFFREY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-01",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6336",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120859",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2018; 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.