Individual provider Active NPI

Amber Harrison, CRNP

  • Family Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1114343639
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-129281 Issued in AL
Practice address
4810 Whitesport Cir SW Ste 110
Huntsville, AL 35801-7439
Phone
(205) 977-9876
NPI assigned
Mar 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-129281 AL Primary

Addresses

Primary practice location

4810 Whitesport Cir SW Ste 110
Huntsville, AL 35801-7439

Mailing address

4021 Balmoral Dr SW
Huntsville, AL 35801-6403
Phone (256) 539-2741

Other practice location 1

802 Bank St NE
Decatur, AL 35601-1612
Phone (256) 351-1874

Other practice location 2

4021 Balmoral Dr SW
Huntsville, AL 35801-6403
Phone (256) 539-2741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140521002168 AL Practitioner - Nurse Practitioner 9436372315 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Alabama Dermatology LLCGroup PAC ID 0143572826, 3 clinicians

Practice addresses (Care Compare)

201 Sivley Rd SW
Suite 410
Huntsville, AL 35801-5146
Phone (256) 536-3738

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-129281ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aqua Dermatology of Alabama PC CurrentSince Jan 1, 2022 Accepting new patients
Jere H. Weaver Past Accepting new patients
Cutaneous Oncology & Surgery Center, LLC Past Accepting new patients

Locations

802 Bank St NE
Decatur, AL 35601
Phone (256) 351-1874

4021 Balmoral Dr SW
Huntsville, AL 35801
Phone (256) 382-0070

4810 Whitesport Cir SW
Ste 110
Huntsville, AL 35801
Phone (256) 539-2531

1940 Stonegate Dr
Ste 140
Vestavia Hls, AL 35242
Phone (205) 968-3919

1940 Stonegate Dr
Ste 130
Vestavia Hls, AL 35242
Phone (205) 451-9481

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1394150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1114343639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 BALMORAL DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358016403",
            "telephone_number": "256-539-2741",
            "fax_number": "256-539-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 WHITESPORT CIR SW STE 110",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358017439",
            "telephone_number": "205-977-9876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "802 Bank St NE",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "AL",
            "postal_code": "356011612",
            "country_code": "US",
            "telephone_number": "256-351-1874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4021 Balmoral Dr SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358016403",
            "country_code": "US",
            "telephone_number": "256-539-2741",
            "fax_number": "256-539-6964",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "AMBER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-07",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-129281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.