Active NPI
Devonja Harris
- Other Technician
- Jackson, TN
National Provider Identifier
1003267717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 539 E Chester St
Jackson, TN 38301-7062 - Phone
- (731) 423-6900
- Fax
- (731) 214-1816
- NPI assigned
- Jun 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
539 E Chester St
Jackson, TN 38301-7062
Mailing address
PO Box 12432
Jackson, TN 38308-0141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geriatric Essentials, PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Geriatric Psychiatry Physician
- Mayfield, KY
- NPI 1043812696
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1003267717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12432",
"city": "JACKSON",
"state": "TN",
"postal_code": "383080141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "539 E CHESTER ST",
"city": "JACKSON",
"state": "TN",
"postal_code": "383017062",
"telephone_number": "731-423-6900",
"fax_number": "731-214-1816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DEVONJA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-23",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.