Laresse Harris, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.022243 Issued in IL

Practice address

1100 W 6TH Ave
Gary, IN 46402-1711

Phone

(219) 885-4264

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Edgewater Systems for Balanced Living IncGroup PAC ID 9234398397, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Methodist Hospitals Inc Hospital, Gary, IN, CCN 150002
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: laresse.harris.p1@direct.edgewater.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Edgewater Systems for Balanced Living, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gary, IN
  • NPI 1588705784

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Edgewater Systems for Balanced Living, Inc

  • Federally Qualified Health Center (FQHC)
  • Gary, IN
  • NPI 1093670648
  NPD
• Edgewater Systems for Balanced Living, Inc

  dba Edgewater Health - Turning Point

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gary, IN
  • NPI 1568955037
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation
• The Methodist Hospitals, Inc

  • General Acute Care Hospital
  • Gary, IN
  • NPI 1467504555
  Care Compare affiliation

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1013516939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 EAS 162ND STREET, STE 573",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "60473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W 6TH AVE",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464021711",
            "telephone_number": "219-885-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LARESSE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalonda Harper
• Ameka Quine'a Harris, B.A.
• Da'Jana Sharamia Harris, BA
• Donna Renee Harris
• Elizabeth Marie Harris, MHT
• Harvest Starts at Home, CDC, Inc. (The Love Center)
• Tonya A. Harvey, NP
• Cory Lee Haston, FNP-C
• Mark Hatch II
• Kemuel Sean Hawkins, LMHC

• Family Nurse Practitioner in Gary, IN
• Providers in Gary, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.