Active NPI
Harry Jethro Harrell, OD
- Optometrist
- Jonesboro, AR
National Provider Identifier
1114088861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2082
- Practice address
- 800 Professional Acres Dr
Jonesboro, AR 72401-4340 - Phone
- (870) 333-1087
- Fax
- (870) 333-1088
- NPI assigned
- Dec 13, 2006
- Last updated
- Jan 19, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2082 | AR | Primary |
Addresses
Primary practice location
800 Professional Acres Dr
Jonesboro, AR 72401-4340
Mailing address
800 Professional Acres Dr
Jonesboro, AR 72401-4340
Phone (870) 333-1087
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 152986722 | Medicaid | AR |
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 |
|---|---|---|---|
| 2082 | AR | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1114088861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 PROFESSIONAL ACRES DR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724014340",
"telephone_number": "870-333-1087",
"fax_number": "870-333-1088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 PROFESSIONAL ACRES DR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724014340",
"telephone_number": "870-333-1087",
"fax_number": "870-333-1088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "HARRY",
"middle_name": "JETHRO",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2082",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "152986722",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.