Active NPI
Timothy Wagner Morgan Jr.
- Immunology Pathology Specialist/Technologist
- Fort Leonard Wood, MO
National Provider Identifier
1962704759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Immunology Pathology Specialist/Technologist
- Practice address
- 200 Oklahoma Ave
Post Immunizations Team
Fort Leonard Wood, MO 65473-8931 - Phone
- (573) 596-1682
- NPI assigned
- Nov 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Immunology Pathology Specialist/Technologist | 246QI0000X | Primary |
Addresses
Primary practice location
200 Oklahoma Ave
Post Immunizations Team
Fort Leonard Wood, MO 65473-8931
Mailing address
200 Oklahoma Ave
Post Immunizations Team
Fort Leonard Wood, MO 65473-8931
Phone (573) 596-1682
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291075200000",
"number": "1962704759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 OKLAHOMA AVE",
"address_2": "POST IMMUNIZATIONS TEAM",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654738931",
"telephone_number": "573-596-1682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 OKLAHOMA AVE",
"address_2": "POST IMMUNIZATIONS TEAM",
"city": "FORT LEONARD WOOD",
"state": "MO",
"postal_code": "654738931",
"telephone_number": "573-596-1682"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORGAN",
"first_name": "TIMOTHY",
"middle_name": "WAGNER",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-30",
"last_updated": "2010-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "246QI0000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Immunology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Leonard Wood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.