Provider Demographics
NPI:1649401159
Name:MORRIS, JESSICA S (PT, DPT, CMTPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PT, DPT, CMTPT
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:S
Other - Last Name:WATTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 69030
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-9030
Mailing Address - Country:US
Mailing Address - Phone:757-873-2302
Mailing Address - Fax:757-873-2306
Practice Address - Street 1:2106 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-2402
Practice Address - Country:US
Practice Address - Phone:757-838-6678
Practice Address - Fax:757-838-8116
Is Sole Proprietor?:No
Enumeration Date:2009-07-31
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305206097225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA192948OtherBCBS (PHYSICAL THERAPY)
VA9585386OtherAETNA
VAP00739441OtherRAILROAD MEDICARE
VA1649401159Medicaid
VA020689T54OtherMEDICARE PTAN
VAC05954OtherGROUP MEDICARE PTAN
VAC05954OtherGROUP MEDICARE PTAN
VA020689T54OtherMEDICARE PTAN