KENNETH WAYNE MORRIS (NPI# 1518023274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518023274 |
| Entity Type | Organization |
| Organization Name | KENNETH WAYNE MORRIS |
| Other Organization Name | PHYSIOLOGICS |
| Practice Address |
4707 Alwood Ct Fort Worth TX 76135-1901 |
| Mailing Address |
Po Box 136372 Fort Worth TX 76136-0372 |
| Practice Telephone | 8172378429 |
| Practice Fax Number | 8172378583 |
| Mailing Telephone | 8172378429 |
| Mailing Fax Number | 8172378583 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. KENNETH WAYNE MORRIS (OWNER) |
| Authorized Official Telephone | 8172378429 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | Z0PL03320 | 05 |
| Other Name | Type Code |
|---|---|
| Physiologics | Doing Business As Name - Organization |
| Street Address |
4707 ALWOOD CT |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76135-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992283501 | Sung Ryel Choi | Dentist | 6014 Azle Ave # 100, Lake Worth, TX 76135 | 2018-08-06 |
| 1750882056 | Kandess Klein | Licensed Vocational Nurse | 8825 Claiborn St, Lakeside, TX 76135 | 2018-02-22 |
| 1841791258 | Robyn Rich | Technician | 5104 Prestwick Drive, Fort Worth, TX 76135 | 2018-02-22 |
| 1598207821 | Young Men's Christian Association of Metropolitan Fort Worth | Health Educator | 5315 Boat Club Rd, Fort Worth, TX 76135 | 2016-11-17 |
| 1558818534 | Clearfork Academy Lp | Substance Abuse Rehabilitation Facility | 7820 Hanger Cut Off, Fort Worth, TX 76135 | 2016-09-07 |
| 1316300999 | National Vision, Inc. | Technician/Technologist | 6014 Azle Ave, Ste 200, Lake Worth, TX 76135 | 2016-04-01 |
| 1457647570 | Cynthia Rosaline Witt | Optometrist | 6014 Azle Avenue, Suite 300, Lake Worth, TX 76135 | 2011-06-27 |
| 1316134125 | Home Town Dental,pa | Dentist | 6332 Lake Worth, Lake Worth, TN 76135 | 2007-09-26 |
| 1790984789 | Jonathan Nicholas Valamides | Optometrist | 6060 Azle Ave. Suite 500, Lake Worth, TX 76135 | 2007-07-11 |
| 1457570053 | Dawn Denise Ezelle | Occupational Therapy Assistant | 3400 Marine Drive, Fort Worth, TX 76135 | 2007-04-24 |
| Find all providers in zip 76135 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services. |
| Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334144 | Sonji M Blanchard | Physiological Laboratory | 8553 N Beach St Ste 224, Fort Worth, TX 76244-4919 | 2020-07-27 |
| 1649753716 | Health Imaging Partners LLC | Physiological Laboratory | 5701 Bryant Irvin Rd Ste 101, Fort Worth, TX 76132-4052 | 2018-09-13 |
| 1104109552 | Health Imaging Partners, LLC | Physiological Laboratory | 2911 Oak Park Circle, Fort Worth, TX 76109 | 2011-09-22 |
| 1144411570 | Fort Worth I Enterprises, LLC Dba Healthy Images of Texas | Physiological Laboratory | 4150 International Plz Ste 600, Fort Worth, TX 76109-4831 | 2007-08-09 |
| 1679525695 | Star Diagnostics of Tarrant County | Physiological Laboratory | 2100 N Main St, Ll20, Fort Worth, TX 76106-8570 | 2006-05-17 |
| 1154379741 | Diagnostic Health Centers of Texas Limited Partnership | Physiological Laboratory | 6001 Harris Pkwy, Fort Worth, TX 76132-4103 | 2006-05-05 |
| 1932166105 | Maxum Health Services Corp | Physiological Laboratory | 1199 8th Ave, Fort Worth, TX 76104-4102 | 2006-04-28 |
| 1366977449 | Usmd Diagnostic Services, LLC | Physiological Laboratory | 5450 Clearfork Main St, Suite 110, Fort Worth, TX 76109-3559 | 2017-04-26 |
| 1083006233 | Btdi Jv, LLP | Physiological Laboratory | 1263 W Rosedale St, Suite 105, Fort Worth, TX 76104-2801 | 2015-02-25 |
| 1104218775 | Btdi Jv, LLP | Physiological Laboratory | 1199 8th Ave, Fort Worth, TX 76104-4102 | 2015-02-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76135 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.