Individual provider Active NPI

Lida Morawetz Jeck, M.D.

  • Psychiatry Physician
  • Durham, NC
National Provider Identifier
1972730794
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
25064 Issued in NC
Practice address
1502 W NC Highway 54 Ste 302
Durham, NC 27707-5572
Phone
(919) 493-5329
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 25064 NC Primary

Addresses

Primary practice location

1502 W NC Highway 54 Ste 302
Durham, NC 27707-5572

Mailing address

1502 W NC Highway 54 Ste 302
Durham, NC 27707-5572
Phone (919) 493-5329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 24, 2012 through Jul 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25064NCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245283200000",
    "number": "1972730794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54 STE 302",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075572",
            "telephone_number": "919-493-5329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W NC HIGHWAY 54 STE 302",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277075572",
            "telephone_number": "919-493-5329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JECK",
        "first_name": "LIDA",
        "middle_name": "MORAWETZ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "25064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.