Individual provider Active NPI

Andrew K Harris, DC

  • Chiropractor
  • Ormond Beach, FL
National Provider Identifier
1104972660
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH11213 Issued in FL
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

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0872747000OtherPAKEYSTONE PROVIDER NUMBER
0872747000OtherPAIBC PROVIDER NUMBER
921050OtherPAHIGHMARK 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

LicenseStateTypeSpecialty
CH11213FLMDChiropractor
DC0074901PAMDChiropractor

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.

Verify at the official NPI Registry.