Bennett Harris, DO

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

74225 Issued in WI

Practice address

3365 S 103Rd St Ste 210
Milwaukee, WI 53227-4161

Phone

(414) 228-4800

Fax

(262) 432-9004

NPI assigned

Apr 27, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Human Services Board Serving North Central Health Care FacilityGroup PAC ID 4385617786, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Human Services Board Serving North Central Health Care Facility

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1205944543
  Medicare reassignment Care Compare group NPD
• Human Services Board Serving North Central Health Care Facility

  • Psychiatric Hospital
  • Wausau, WI
  • NPI 1932714292
  NPD
• Human Services Board Serving North Central Heatlh Care Facility

  • Multi-Specialty Clinic/Center
  • Wausau, WI
  • NPI 1821106162
  NPD

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1033596176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST STE 210",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161",
            "telephone_number": "414-228-4800",
            "fax_number": "262-432-9004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3365 S 103RD ST STE 210",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274161",
            "telephone_number": "414-228-4800",
            "fax_number": "262-432-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BENNETT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.154123",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "34.014710",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WI",
            "license": "74225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033596176",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laquanna P Harris-Arms
• Aileen Harris
• Alexandria Samone Harris
• Alondra Patrice Harris, PHARMD
• Angela D Harris
• Carla Harris, RN
• Carlese Harris
• Carlethia Harris, APNP
• Carmelia Harris
• Chantil Harris, M.A

• Child & Adolescent Psychiatry Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Child & Adolescent Psychiatry Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.