Active NPI
Teaonna D Harris, CCHW, PBT
- Community Health Worker
- Indianapolis, IN
National Provider Identifier
1053142414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- 0230144404
- Practice address
- 801 Shelby St # 513
Indianapolis, IN 46203-1163 - Phone
- (877) 355-0305
- Fax
- (317) 429-1678
- NPI assigned
- Aug 8, 2024
- Last updated
- Aug 8, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | |||
| Adult Companion | 372600000X | |||
| Day Training/Habilitation Specialist | 373H00000X | |||
| Personal Emergency Response Attendant | 146D00000X | |||
| Technician/Technologist | 156F00000X | |||
| Contractor | 171W00000X | |||
| Driver | 172A00000X | |||
| Art Therapist | 221700000X | |||
| Music Therapist | 225A00000X | |||
| Phlebotomy Technician | 246RP1900X | |||
| Health Information Specialist/Technologist | 246Y00000X | |||
| Community Health Worker | 172V00000X | 0230144404 | IN | Primary |
| Supports Brokerage Agency | 251X00000X | |||
| Health Educator | 174H00000X | |||
| Health & Wellness Coach | 171400000X |
Addresses
Primary practice location
801 Shelby St # 513
Indianapolis, IN 46203-1163
Mailing address
801 Shelby St # 513
Indianapolis, IN 46203-1163
Phone (877) 355-0305
Other practice location 1
3321 Chamberlin Dr
Indianapolis, IN 46237-1512
Phone (317) 864-8641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0230144404 | IN | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723075200000",
"number": "1053142414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "801 SHELBY ST # 513",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462031163",
"telephone_number": "877-355-0305",
"fax_number": "317-429-1678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 SHELBY ST # 513",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462031163",
"telephone_number": "877-355-0305",
"fax_number": "317-429-1678"
}
],
"practiceLocations": [
{
"address_1": "3321 Chamberlin Dr",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462371512",
"country_code": "US",
"telephone_number": "317-864-8641",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "TEAONNA",
"middle_name": "D",
"name_prefix": "Ms.",
"credential": "CCHW, PBT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-08",
"last_updated": "2024-08-08",
"certification_date": "2024-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "251K00000X",
"taxonomy_group": "",
"desc": "Public Health or Welfare",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "373H00000X",
"taxonomy_group": "",
"desc": "Day Training/Habilitation Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "146D00000X",
"taxonomy_group": "",
"desc": "Personal Emergency Response Attendant",
"state": null,
"license": null,
"primary": false
},
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": false
},
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": null,
"license": null,
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": null,
"license": null,
"primary": false
},
{
"code": "246Y00000X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Health Information",
"state": null,
"license": null,
"primary": false
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "IN",
"license": "0230144404",
"primary": true
},
{
"code": "251X00000X",
"taxonomy_group": "",
"desc": "Supports Brokerage",
"state": null,
"license": null,
"primary": false
},
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": false
},
{
"code": "171400000X",
"taxonomy_group": "",
"desc": "Health & Wellness Coach",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.