Khealynn Fernelius Harris, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60586603 Issued in WA

Practice address

202 Cullens St NW
Yelm, WA 98597-9417

Phone

(801) 857-8001

NPI assigned

Aug 6, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1689814022
  Medicare reassignment NPD
• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hilo, HI
  • NPI 1225086887
  NPD
• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Pahoa, HI
  • NPI 1265482624
  NPD
• West Hawaii Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hilo, HI
  • NPI 1487256491
  NPD
• Molokai Ohana Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Kaunakakai, HI
  • NPI 1336805621
  NPD (past)

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445212800000",
    "number": "1083090567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 CULLENS ST NW",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985979417",
            "telephone_number": "801-857-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 CULLENS ST NW",
            "city": "YELM",
            "state": "WA",
            "postal_code": "985979417",
            "telephone_number": "801-857-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KHEALYNN",
        "middle_name": "FERNELIUS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60586603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Hanan, LMHCA
• Konni Hansen
• Erica Harkin, PHARM. D.
• Sydney Elizabeth Harrell, PHARMD
• Jennifer June Harris
• Iris Harrison, LMP
• Vanessa Hartley, RN
• Brian Harvey, DNP, ARNP, FNP-BC
• Heart 2 Heart Homecare LLC
• Mariana M Heinitz, DPT

• General Practice Dentistry in Yelm, WA
• Providers in Yelm, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.