Individual provider Active NPI

Ralph W Morales, DO

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Brunswick, GA
National Provider Identifier
1790773703
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
31480 Issued in GA
Practice address
3231 Glynn Ave
Brunswick, GA 31520-4851
Phone
(912) 265-9006
Fax
(912) 265-7200
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 31480 GA Primary

Addresses

Primary practice location

3231 Glynn Ave
Brunswick, GA 31520-4851

Mailing address

3231 Glynn Ave
Brunswick, GA 31520-4851
Phone (912) 265-9006

Other identifiers 1

IdentifierTypeStateIssuer
00612675EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20101116001049 GA Practitioner - Orthopedic Surgery 6608988977 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Orthopaedics and Sports Medicine, P.C. CurrentSince Sep 1, 1996 Accepting new patients
Southern Orthopaedics and Sports Medicine Current Accepting new patients

Locations

3231 Glynn Ave
Brunswick, GA 31520
Phone (912) 265-9006

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IEDAAA

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1790773703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3231 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204851",
            "telephone_number": "912-265-9006",
            "fax_number": "912-265-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 GLYNN AVE",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315204851",
            "telephone_number": "912-265-9006",
            "fax_number": "912-265-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "RALPH",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "GA",
            "license": "31480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00612675E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.