Active NPI
Kenneth J Morrissey, MD
- Sports Medicine (Orthopaedic Surgery) Physician
- Cranston, RI
National Provider Identifier
1790859064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician
- License
- MD06506
- Practice address
- 1150 Reservoir Avenue
Suite 200
Cranston, RI 02920-6064 - Phone
- (401) 944-8700
- Fax
- (401) 944-8767
- NPI assigned
- Nov 20, 2006
- Last updated
- Jun 22, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | MD06506 | RI | Primary |
Addresses
Primary practice location
1150 Reservoir Avenue
Suite 200
Cranston, RI 02920-6064
Mailing address
1150 Reservoir Avenue
Suite 200
Cranston, RI 02920-6064
Phone (401) 944-8700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9002080 | Medicaid | RI | |
| 200054 | Other | RI | BLUE CHIP |
| 2080 | Other | RI | BC |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD06506 | RI | MD | Sports Medicine (Orthopaedic Surgery) Physician |
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.
-
- Orthopaedic Surgery Physician
- Cranston, RI
- NPI 1164540753
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498089600000",
"number": "1790859064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 RESERVOIR AVENUE",
"address_2": "SUITE 200",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029206064",
"telephone_number": "401-944-8700",
"fax_number": "401-944-8767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 RESERVOIR AVENUE",
"address_2": "SUITE 200",
"city": "CRANSTON",
"state": "RI",
"postal_code": "029206064",
"telephone_number": "401-944-8700",
"fax_number": "401-944-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISSEY",
"first_name": "KENNETH",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2017-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "RI",
"license": "MD06506",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9002080",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "200054",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC",
"identifier": "2080",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cranston, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.