Carolyn K Harris, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0017000378 Issued in VA

Practice address

2215 Landover PL
Lynchburg, VA 24501-2115

Phone

(434) 947-3944

Fax

(434) 544-2316

NPI assigned

Nov 22, 2005

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

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Lynchburg Nephrology Physicians PLLC

  • Specialist
  • Lynchburg, VA
  • NPI 1053498071
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1083697262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11889",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245061889",
            "telephone_number": "434-947-3944",
            "fax_number": "434-544-2316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 LANDOVER PL",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245012115",
            "telephone_number": "434-947-3944",
            "fax_number": "434-544-2316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CAROLYN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0017000378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER PRIOR TO 09/01/07",
            "identifier": "013531C83",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN EFFECTIVE TO 09/01/07",
            "identifier": "014912C58",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN EFFECTIVE 09/01/07",
            "identifier": "C03658",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083697262",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CVFP SITE ID",
            "identifier": "1407936941",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00667138",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NPI NUMBER",
            "identifier": "1528155892",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER PRIOR TO 09/01/07",
            "identifier": "C08183",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alva Harold
• Alyssa Harold, LPC
• Brianna Lee Harper, STUDENT, HEALTH CARE
• Andrea Nuckols Harris, NP
• Brooke Nicole Harris, COTA/L
• Jordan Harris
• Joshua Michael Harris
• Kyleigh Idell Harris
• Latoya Harris
• Mackenzie Roberta Harris

• Nurse Practitioner in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2009; 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.