Individual provider Active NPI

Caroline Harris

  • Psychiatric/Mental Health Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1124032255
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN00000011704 Issued in TN
Practice address
6000 Poplar Ave Ste 250
Memphis, TN 38119-3974
Phone
(574) 546-1900
NPI assigned
Jul 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN00000011704 TN Primary

Addresses

Primary practice location

6000 Poplar Ave Ste 250
Memphis, TN 38119-3974

Mailing address

912 Acklen Ave
Nashville, TN 37203-5410

Other identifiers 1

IdentifierTypeStateIssuer
11704OtherTNSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20070117000147 TN Practitioner - Nurse Practitioner 4284635350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11704TNMDSpecialist
APN00000011704TNMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Feb 23, 2015 Accepting new patients
Saint Thomas Medical Partners CurrentSince Feb 23, 2015 Accepting new patients
Centerstone of Tennessee, Inc. PastSince Jul 3, 2010 Accepting new patients
Centerstone of Tennessee, Inc. Past Accepting new patients

Locations

501 Great Circle Rd
Ste 200
Nashville, TN 37228
Phone (615) 396-4694

300 20th Ave N
Fl 9
Nashville, TN 37203

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1124032255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 ACKLEN AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372035410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 POPLAR AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193974",
            "telephone_number": "574-546-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "APN00000011704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "11704",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.