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  7. NPI Record 1235139023

ALONZO KEVIN MORRISSEY MD
Complete NPI Record 1235139023
Family Medicine in St John, IN

NPI Status: Active since July 22, 2005

Contact Information

9660 WICKER AVE
ST JOHN, IN
ZIP 46373
Phone: (219) 365-1166
Fax: (219) 365-8852

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Credential Text
  7. Provider First Line Business Mailing Address
  8. Provider Business Mailing Address City Name
  9. Provider Business Mailing Address State Name
  10. Provider Business Mailing Address Postal Code
  11. Provider Business Mailing Address Country Code If outside U S
  12. Provider Business Mailing Address Telephone Number
  13. Provider Business Mailing Address Fax Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Business Practice Location Address Fax Number
  21. Provider Enumeration Date
  22. Last Update Date
  23. Provider Gender Code
  24. Healthcare Provider Taxonomy Code 1
  25. Provider License Number 1
  26. Provider License Number State Code 1
  27. Healthcare Provider Primary Taxonomy Switch 1
  28. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1235139023. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1235139023
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: ALONZO
The first name of the provider, if the provider is an individual.
Provider Middle Name: KEVIN
The middle name of the provider, if the provider is an individual.
Provider Credential Text: MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 9660 WICKER AVE
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: ST JOHN
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: IN
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address Postal Code: 463739487
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Business Mailing Address Telephone Number: 2193651166
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address Fax Number: 2193658852
The city name in the mailing address of the provider being identified.
Provider First Line Business Practice Location Address: 9660 WICKER AVE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Practice Location Address City Name: ST JOHN
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Practice Location Address State Name: IN
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Practice Location Address Postal Code: 463739487
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Practice Location Address Country Code If outside U S : US
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider Business Practice Location Address Telephone Number: 2193651166
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address Fax Number: 2193658852
The city name in the location address of the provider being identified.
Provider Enumeration Date: 7/22/2005
The State code in the location of the provider being identified.
Last Update Date: 7/8/2007
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Gender Code: M
The country code in the location address of the provider being identified.
Healthcare Provider Taxonomy Code 1: 207Q00000X
The telephone number associated with the location address of the provider being identified.
Provider License Number 1: 01028441
The fax number associated with the location address of the provider being identified.
Provider License Number State Code 1: IN
The date the provider was assigned a unique identifier (assigned an NPI).
Healthcare Provider Primary Taxonomy Switch 1: Y
The date that a record was last updated or changed.
Is Sole Proprietor: X
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.