Individual provider Active NPI

Jeffery C Morissette, D.O.

  • Diagnostic Radiology Physician
  • Phoenix, AZ
National Provider Identifier
1821060864
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1961 Issued in AZ
Practice address
19829 N 27TH Ave
Phoenix, AZ 85027-4001
Phone
(623) 879-5720
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1961 AZ Primary

Addresses

Primary practice location

19829 N 27TH Ave
Phoenix, AZ 85027-4001

Mailing address

PO Box 27340
Phoenix, AZ 85061-7340
Phone (602) 943-9200

Other identifiers 3

IdentifierTypeStateIssuer
841214MedicaidAZ
1Z7086OtherAZHEALTH NET OF AZ
AZ0221810OtherAZBCBSAZ

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 Osteopathy

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1821060864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27340",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850617340",
            "telephone_number": "602-943-9200",
            "fax_number": "602-216-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19829 N 27TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274001",
            "telephone_number": "623-879-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORISSETTE",
        "first_name": "JEFFERY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "1961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "841214",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET OF AZ",
            "identifier": "1Z7086",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAZ",
            "identifier": "AZ0221810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.