Individual provider Active NPI

Jessica Mary Harris, N.P. - C

  • Adult Health Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1023316940
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024169243 Issued in VA
Practice address
9530 Cosner Dr Ste 200
Fredericksburg, VA 22408-7760
Phone
(540) 373-1331
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024169243 VA Primary

Addresses

Primary practice location

9530 Cosner Dr Ste 200
Fredericksburg, VA 22408-7760

Mailing address

9530 Cosner Dr Ste 200
Fredericksburg, VA 22408-7760
Phone (540) 373-1331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, VA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131125001081 GA Practitioner - Nurse Practitioner 6800022708
I20260511002446 VA Practitioner - Nurse Practitioner 6800022708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

140 Vista Centre Dr
Forest, VA 24551-3965

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024169243VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Group LLC Current Accepting new patients
University Prompt Care Current Accepting new patients
University Health Care Physicians LLC Current Accepting new patients

Locations

820 Saint Sebastian Way
Ste 4C
Augusta, GA 30901
Phone (706) 774-5997

447 N Belair Rd
Ste 101
Evans, GA 30809
Phone (706) 854-2222

447 N Belair Rd
Ste 104
Evans, GA 30809
Phone (706) 854-2180

Interoperability endpoints

  • Direct secure messaging: jessica.harris.p1@direct.nextgencaf20.nextgenshare.com
  • Direct secure messaging: jessica.harris.1@17026.direct.athenahealth.com

Organizations & group practices 4

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": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1023316940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9530 COSNER DR STE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087760",
            "telephone_number": "540-373-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9530 COSNER DR STE 200",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224087760",
            "telephone_number": "540-373-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JESSICA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "N.P. - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024169243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.