NPIMap

Individual provider Active NPI

John Michael Harkless, D.O.

  • Family Medicine Physician
  • Wytheville, VA
National Provider Identifier
1083870455
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0102202346 Issued in VA
Practice address
1040 Holston Rd
Wytheville, VA 24382-4107
Phone
(276) 227-0200
Fax
(276) 227-0202
NPI assigned
Aug 5, 2008
Last updated
Mar 30, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS-014404 PA
Family Medicine Physician 207Q00000X 0102202346 VA Primary

Addresses

Primary practice location

1040 Holston Rd
Wytheville, VA 24382-4107

Mailing address

340 Peppers Ferry Rd
Suite C
Wytheville, VA 24382-2056
Phone (276) 227-0200

Other identifiers 1

IdentifierTypeStateIssuer
1083870455MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20090820000782 VA Practitioner - Family PracticePractitioner - DermatologyPractitioner - Osteopathic Manipulative MedicinePractitioner - Emergency Medicine 5890849178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Dermatology, Emergency Medicine, Osteopathic Manipulative Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1040 Holston Rd
Wytheville, VA 24382-4107
Phone (276) 227-0200

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
OS-014404PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare of Wytheville, PC Family Medicine CurrentSince Jul 1, 2009 Accepting new patients

Locations

1040 Holston Rd
Wytheville, VA 24382
Phone (276) 227-0200

340 Peppers Ferry Rd
Ste C
Wytheville, VA 24382
Phone (276) 227-0200

Interoperability endpoints

  • Direct secure messaging: john.harkless.1@16740.direct.athenahealth.com

Organizations & group practices 1

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 7

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

NPI Registry JSON

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1083870455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 PEPPERS FERRY RD",
            "address_2": "SUITE C",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822056",
            "telephone_number": "276-227-0200",
            "fax_number": "276-227-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HOLSTON RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243824107",
            "telephone_number": "276-227-0200",
            "fax_number": "276-227-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARKLESS",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-05",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS-014404",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102202346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083870455",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.