Individual provider Active NPI

Gillian Amber Morris, MD

  • Family Medicine Physician
  • Providence, RI
National Provider Identifier
1922480821
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD16324 Issued in RI
Practice address
450 Brook St
Providence, RI 02912-5615
Phone
(401) 863-3953
Fax
(401) 863-7953
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 264650 MA
Family Medicine Physician 207Q00000X MD16324 RI Primary

Addresses

Primary practice location

450 Brook St
Providence, RI 02912-5615

Mailing address

450 Brook St
Providence, RI 02906-2231
Phone (401) 863-3953

Other practice location 1

2100 Dorchester Ave
Boston, MA 02124-5615
Phone (617) 506-4970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160215002171 RI Order and Referring Only - Obstetrics/GynecologyPractitioner - Obstetrics/Gynecology 4385948132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
264650MAMDFamily Medicine Physician
MD16324RIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1922480821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 BROOK ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062231",
            "telephone_number": "401-863-3953",
            "fax_number": "401-863-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 BROOK ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029125615",
            "telephone_number": "401-863-3953",
            "fax_number": "401-863-7953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Dorchester Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021245615",
            "country_code": "US",
            "telephone_number": "617-506-4970",
            "fax_number": "617-474-3820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "GILLIAN",
        "middle_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "264650",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD16324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.