NPIMap

Individual provider Active NPI

John Harris, M.D.

  • Internal Medicine Physician
  • Bellevue, NE
National Provider Identifier
1043360043
Registry record updated Jan 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20112 Issued in NE
Practice address
3308 Samson Way
Bellevue, NE 68123-3234
Phone
(402) 827-1577
Fax
(402) 898-3134
NPI assigned
Jan 11, 2007
Last updated
Jan 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20112 NE Primary

Addresses

Primary practice location

3308 Samson Way
Bellevue, NE 68123-3234

Mailing address

7261 Mercy Rd
Omaha, NE 68124-2311
Phone (402) 398-6254

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100327000096 NE Practitioner - Internal Medicine 7517093750 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Nebraska College of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alegent Creighton ClinicGroup PAC ID 1951210418, 951 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

11109 S 84TH St
Suite 5800
Papillion, NE 68046-4124
Phone (402) 827-4900

11111 S 84TH St
Papillion, NE 68046-4122
Phone (402) 898-2520

16909 Lakeside Hills CT
Omaha, NE 68130-4661

2600 Compass Rd
Glenview, IL 60026-8001

3308 Samson Way
Bellevue, NE 68123-3234
Phone (402) 291-3373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions19
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Alegent Creighton Clinic CurrentSince Sep 1, 2000 Accepting new patients
Alegent Creighton Health Past Accepting new patients
Omaha Nursing Home Inc Past Accepting new patients
VSL Papillion LLC Past Accepting new patients
Red Oak Health Services Inc Past Accepting new patients
Alegent Creighton Clinic Internal Medicine Past Accepting new patients
CHI National Home Care, LLC Past Accepting new patients
Consolidated Resources Health Care Fund I, L.P. Past Accepting new patients

Locations

2771 Solution Ctr
Chicago, IL 60677

3308 Samson Way
Bellevue, NE 68123
Phone (402) 291-3373

16909 Lakeside Hills Ct
Ste 401
Omaha, NE 68130
Phone (402) 827-4920

7261 Mercy Rd
Omaha, NE 68124
Phone (402) 398-6248

11109 S 84th St
Ste 1820
Papillion, NE 68046
Phone (402) 827-1577

11109 S 84th St
Ste 5800
Papillion, NE 68046
Phone (402) 827-1577

Networks

  • IA HMO C-SNP
  • CO HMO
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • IA HMO
  • CO HMO C-SNP

Interoperability endpoints

  • Direct secure messaging: john.harris.1@23757.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brookestone of PapillionPapillion, NE, CCN 285268 Skilled nursing facility Contracted Managing Employee
Operational/Managerial Control		 Feb 15, 2019
Feb 15, 2019
CHI Health at Home - OmahaOmaha, NE, CCN 281500 Hospice Contracted Managing Employee Jan 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 9

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.

Hospital & facility affiliations 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1043360043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7261 MERCY RD",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242311",
            "telephone_number": "402-398-6254",
            "fax_number": "402-829-8513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3308 SAMSON WAY",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681233234",
            "telephone_number": "402-827-1577",
            "fax_number": "402-898-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "20112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

Verify at the official NPI Registry.