Jerry Wayne Harris, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

326 Issued in NC

Practice address

5323 Fox Cove LN
U
Greensboro, NC 27407-5961

Phone

(336) 638-3700

NPI assigned

Jun 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013953876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39721",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274389721",
            "telephone_number": "336-638-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 FOX COVE LN",
            "address_2": "U",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274075961",
            "telephone_number": "336-638-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JERRY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890808E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diannah Carol Harris, MA, LCMHC,LCASA,CCTP
• Fatima Laquita Harris
• Florendia L. Harris
• Ian Winfred Harris, PTA
• Jacqueline Harris, LCMHC
• Kathy M Harris, NP
• Kenneth Ray Harris
• Kristie Harris
• Laura Wade Harris
• Lelia Harris

• Podiatrist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.