Individual provider Active NPI

Cameo Celisse Harris

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Charlotte, NC
National Provider Identifier
1053284414
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Intellectual and/or Developmental Disabilities Respite CareTaxonomy code 385HR2060X
License
60001352 Issued in NC
Practice address
6300 Farm Pond LN
Charlotte, NC 28212-1758
Phone
(704) 649-7454
NPI assigned
Sep 23, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 60001352 NC Primary

Addresses

Primary practice location

6300 Farm Pond LN
Charlotte, NC 28212-1758

Mailing address

6300 Farm Pond LN
Charlotte, NC 28212-1758
Phone (704) 649-7454

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

LicenseStateTypeSpecialty
60001352NCMDChild Intellectual and/or Developmental Disabilities Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1053284414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 FARM POND LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282121758",
            "telephone_number": "704-649-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 FARM POND LN",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282121758",
            "telephone_number": "704-649-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CAMEO",
        "middle_name": "CELISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "NC",
            "license": "60001352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.