Active NPI
Andrew K Harris, DC
- Chiropractor
- Ormond Beach, FL
National Provider Identifier
1104972660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CH11213
- Practice address
- 175 S Nova Rd Ste 6a
Ormond Beach, FL 32174-0407 - Phone
- (386) 677-9355
- NPI assigned
- Jan 26, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC0074901 | PA | |
| Chiropractor | 111N00000X | CH11213 | FL | Primary |
Addresses
Primary practice location
175 S Nova Rd Ste 6a
Ormond Beach, FL 32174-0407
Mailing address
PO Box 337
Ormond Beach, FL 32175-0337
Phone (386) 677-9355
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0872747000 | Other | PA | KEYSTONE PROVIDER NUMBER |
| 0872747000 | Other | PA | IBC PROVIDER NUMBER |
| 921050 | Other | PA | HIGHMARK PROVIDER NUMBER |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH11213 | FL | MD | Chiropractor |
| DC0074901 | PA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1104972660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 337",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321750337",
"telephone_number": "386-677-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 S NOVA RD STE 6A",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321740407",
"telephone_number": "386-677-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ANDREW",
"middle_name": "K",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-26",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC0074901",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "FL",
"license": "CH11213",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KEYSTONE PROVIDER NUMBER",
"identifier": "0872747000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC PROVIDER NUMBER",
"identifier": "0872747000",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK PROVIDER NUMBER",
"identifier": "921050",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.