Individual provider Active NPI

Roger Jack Harris Jr., D.C.

  • Chiropractor
  • Barboursville, WV
National Provider Identifier
1003855669
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
722 Issued in WV
Practice address
6430 US Route 60 E
Barboursville, WV 25504-1240
Phone
(304) 736-4111
Fax
(304) 736-0334
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 722 WV Primary

Addresses

Primary practice location

6430 US Route 60 E
Barboursville, WV 25504-1240

Mailing address

6430 US Route 60 E
Barboursville, WV 25504-1240
Phone (304) 736-4111

Other identifiers 1

IdentifierTypeStateIssuer
7600098000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126000831 WV Practitioner - Chiropractic 0648459370 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harris Chiropractic, Inc. Chiropractor CurrentSince Jan 2, 2001 Accepting new patients
Carlton & Harris Chiropractic Inc Chiropractor Past Accepting new patients

Locations

6430 US Route 60 E
Barboursville, WV 25504
Phone (304) 736-0334

3246 US Route 60
Ste 9
Huntington, WV 25705

Interoperability endpoints

  • Direct secure messaging: rharris@dc0010.direct.chirotouch.md

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1003855669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6430 US ROUTE 60 E",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041240",
            "telephone_number": "304-736-4111",
            "fax_number": "304-736-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 US ROUTE 60 E",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041240",
            "telephone_number": "304-736-4111",
            "fax_number": "304-736-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROGER",
        "middle_name": "JACK",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600098000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Barboursville, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.