Individual provider Active NPI

Gregory Wayne Morris, PTA

  • Physical Therapy Assistant
  • Brandon, FL
National Provider Identifier
1861795130
Registry record updated Dec 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA19408 Issued in FL
Practice address
205 S Moon Ave Ste 104
Brandon, FL 33511-5716
Phone
(813) 651-3900
Fax
(813) 651-3911
NPI assigned
Dec 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA19408 FL Primary

Addresses

Primary practice location

205 S Moon Ave Ste 104
Brandon, FL 33511-5716

Mailing address

PO Box 7746
Saint Petersburg, FL 33734-7746
Phone (727) 898-5001

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA19408FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy and Sports Center, Inc. Past Accepting new patients
Therapy & Sports Center, Inc. Past Accepting new patients

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": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1861795130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7746",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337347746",
            "telephone_number": "727-898-5001",
            "fax_number": "727-894-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S MOON AVE STE 104",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115716",
            "telephone_number": "813-651-3900",
            "fax_number": "813-651-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "GREGORY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA19408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; 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.