Active NPI
Robert Harrison Jr.
- Surgery Physician
- Westerly, RI
National Provider Identifier
1104869858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD06502
- Practice address
- 25 Wells Street
Westerly, RI 02891 - Phone
- (401) 364-1950
- Fax
- (401) 364-1902
- NPI assigned
- Jun 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD06502 | RI | Primary |
| Surgery Physician | 208600000X | 25961 | CT |
Addresses
Primary practice location
25 Wells Street
Westerly, RI 02891
Mailing address
36M Bader Lane
Hope Valley, RI 02832
Phone (401) 364-1950
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25961 | CT | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104869858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36M BADER LANE",
"city": "HOPE VALLEY",
"state": "RI",
"postal_code": "02832",
"telephone_number": "401-364-1950",
"fax_number": "401-364-1902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 WELLS STREET",
"city": "WESTERLY",
"state": "RI",
"postal_code": "02891",
"telephone_number": "401-364-1950",
"fax_number": "401-364-1902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "ROBERT",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "RI",
"license": "MD06502",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CT",
"license": "25961",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westerly, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.