Individual provider Active NPI

Leisa E Morris, APRN-FNP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1861940785
Registry record updated Oct 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000021511 Issued in TN
Practice address
400 N State of Franklin Rd FL 4
Johnson City, TN 37604-6035
Phone
(423) 282-1480
Fax
(423) 928-1353
NPI assigned
Sep 20, 2016
Last updated
Oct 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000021511 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd FL 4
Johnson City, TN 37604-6035

Mailing address

PO Box 4018
Johnson City, TN 37602-4018
Phone (423) 282-1480

Other identifiers 1

IdentifierTypeStateIssuer
Q026329MedicaidTN

Other names 1

  • Leisa Ellis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161108000693 TN Practitioner - Nurse Practitioner 8123307550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1497 W Elk Ave
Elizabethton, TN 37643-2896

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4847

408 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-4946

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0000021511TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation CurrentSince Jan 30, 2018 Accepting new patients
Southeastern Physician Services PC CurrentSince Jan 13, 2017 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Jan 30, 2018 Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

400 N State of Franklin Rd
Fl 4
Johnson City, TN 37604
Phone (423) 431-1961

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Organizations & group practices 4

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508716800000",
    "number": "1861940785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4018",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376024018",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD FL 4",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-282-1480",
            "fax_number": "423-928-1353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "LEISA",
        "middle_name": "E",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2017-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000021511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026329",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEISA",
            "last_name": "ELLIS",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.