Active NPI
Keith Hideo Morita, M.D.
- Family Medicine Physician
- Lackland a F B, TX
National Provider Identifier
1972662971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD055068L
- Practice address
- 2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907 - Phone
- (210) 292-3674
- NPI assigned
- Dec 6, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD055068L | PA | Primary |
Addresses
Primary practice location
2200 Bergquist Dr
Suite 1
Lackland a F B, TX 78236-9907
Mailing address
7718 Moss Brook Dr
San Antonio, TX 78255-1305
Phone (210) 372-9549
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD055068L | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972662971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7718 MOSS BROOK DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782551305",
"telephone_number": "210-372-9549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 BERGQUIST DR",
"address_2": "SUITE 1",
"city": "LACKLAND A F B",
"state": "TX",
"postal_code": "782369907",
"telephone_number": "210-292-3674"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORITA",
"first_name": "KEITH",
"middle_name": "HIDEO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD055068L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lackland a F B, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.