Individual provider Active NPI

Mark Morris, M.D.

  • Pediatrics Physician
  • St Petersburg, FL
National Provider Identifier
1932137759
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME27038 Issued in FL
Practice address
1800 9TH St N
St Petersburg, FL 33704-4222
Phone
(727) 821-9343
Fax
(727) 822-3285
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME27038 FL Primary

Addresses

Primary practice location

1800 9TH St N
St Petersburg, FL 33704-4222

Mailing address

1033 Dr Martin Luther King Jr St N
Suite 108
St Petersburg, FL 33701-1547
Phone (727) 456-4250

Other identifiers 2

IdentifierTypeStateIssuer
52914ZOtherFLMEDICARE PTAN
035541100MedicaidFL

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 Medicine

State licenses

LicenseStateTypeSpecialty
ME27038FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Pediatric Associates, LLC Pediatrics PastSince Apr 30, 2003 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mark.morris.1@18455.direct.athenahealth.com

Organizations & group practices 1

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1932137759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 DR MARTIN LUTHER KING JR ST N",
            "address_2": "SUITE 108",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337011547",
            "telephone_number": "727-456-4250",
            "fax_number": "727-346-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 9TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044222",
            "telephone_number": "727-821-9343",
            "fax_number": "727-822-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME27038",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "52914Z",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035541100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.