Provider Demographics
NPI:1861729782
Name:MORTON, LARRY WILLIAM (CPO, CPED, FAAOP)
Entity type:Individual
Prefix:MR
First Name:LARRY
Middle Name:WILLIAM
Last Name:MORTON
Suffix:
Gender:M
Credentials:CPO, CPED, FAAOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 SAINT LEOS STREET
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-3382
Mailing Address - Country:US
Mailing Address - Phone:336-621-9500
Mailing Address - Fax:336-621-0313
Practice Address - Street 1:1352 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4985
Practice Address - Country:US
Practice Address - Phone:704-841-4388
Practice Address - Fax:704-849-7727
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1732225000000X
CPO01732222Z00000X, 224P00000X
CPED0326224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7795139Medicaid
NC1275616211Medicare PIN
NC7795139Medicaid
NC1265515225Medicare PIN
NC0521240001Medicare NSC