Organization Active NPI

Morse Clinic of Durham, PC

  • Community/Behavioral Health Agency
  • Durham, NC
National Provider Identifier
1861069080
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MORSE CLINIC OF DURHAM, PC
Practice address
4119 Capitol St
Durham, NC 27704-2153
Phone
(919) 294-9621
Fax
(919) 294-9794
NPI assigned
Jun 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Mrs. Lisa Michelle Kornegay, LCAS
Title
Ceo
Phone
(919) 294-9621

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

4119 Capitol St
Durham, NC 27704-2153

Mailing address

4119 Capitol St
Durham, NC 27704-2153
Phone (919) 294-9621

Other identifiers 1

IdentifierTypeStateIssuer
251S00000XMedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkornegay@morseclinics.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Opioid treatment program
Medicare-enrolled since Sep 1, 2023

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231027002044 NC Part B Supplier - Opioid Treatment Program (Otp) 3274901145 Practice locations: Durham, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2240997Morse Clinic of Durham, PC4119 Capitol Street, Durham, NC 27704Certificate of waiverOct 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1861069080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 CAPITOL ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042153",
            "telephone_number": "919-294-9621",
            "fax_number": "919-294-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 CAPITOL ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042153",
            "telephone_number": "919-294-9621",
            "fax_number": "919-294-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORSE CLINIC OF DURHAM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "KORNEGAY",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-294-9621",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCAS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251S00000X",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkornegay@morseclinics.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mkornegay@morseclinics.com",
            "address_1": "4119 Capitol St",
            "city": "Durham",
            "state": "NC",
            "country_code": "US",
            "postal_code": "277042153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.