Individual provider Active NPI

David O'Neal Morris Jr., CHIROPRACTOR

  • Chiropractor
  • Homerville, GA
National Provider Identifier
1790369668
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
004765 Issued in GA
Practice address
53 Lisa Rd
Homerville, GA 31634-1512
Phone
(912) 520-1448
NPI assigned
May 7, 2021
Last updated
May 7, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 004765 GA Primary

Addresses

Primary practice location

53 Lisa Rd
Homerville, GA 31634-1512

Mailing address

53 Lisa Rd
Homerville, GA 31634-1512
Phone (912) 520-1448

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626004238 SD Practitioner - Chiropractic 9234532250 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004765GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Micko Chiropractic PC CurrentSince May 12, 2025 Accepting new patients

Organizations & group practices 1

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": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1790369668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 LISA RD",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316341512",
            "telephone_number": "912-520-1448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 LISA RD",
            "city": "HOMERVILLE",
            "state": "GA",
            "postal_code": "316341512",
            "telephone_number": "912-520-1448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "DAVID",
        "middle_name": "O'NEAL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "004765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homerville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.