Individual provider Active NPI

Amy K Harris, N.P

  • Nurse Practitioner
  • Union City, TN
National Provider Identifier
1124034541
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0103714 Issued in TN
Practice address
1109 E Reelfoot Ave Ste F
Union City, TN 38261-5867
Phone
(731) 884-1412
Fax
(731) 884-1720
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0103714 TN Primary

Addresses

Primary practice location

1109 E Reelfoot Ave Ste F
Union City, TN 38261-5867

Mailing address

PO Box 405827
Atlanta, GA 30384-5800

Other identifiers 1

IdentifierTypeStateIssuer
1750514410OtherTNGROUP NPI

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
I20050222000896 TN Practitioner - Nurse Practitioner 9739132440 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Memorial Hospital-TiptonGroup PAC ID 6709878614, 29 clinicians

Practice addresses (Care Compare)

1109 E Reelfoot Ave
Suite Gandh
Union City, TN 38261-5856
Phone (731) 884-1720

1995 Hwy 51 S
Covington, TN 38019-3635
Phone (901) 476-2621

Hospital & facility affiliations

  • Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7112TNMDPediatric Occupational Therapist
0103714TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Memorial Medical Group Inc CurrentSince Jun 1, 2016 Accepting new patients
Baptist Memorial Medical Group Inc Nurse Practitioner CurrentSince Jun 1, 2016 Accepting new patients
Baptist Memorial Hospital-Tipton CurrentSince Aug 24, 2018 Accepting new patients
Baptist Memorial Hospital-Tipton CurrentSince Aug 24, 2018 Accepting new patients
Integrity Oncology, PLLC Past Accepting new patients

Locations

36 Capital Way
Ste E
Atoka, TN 38004
Phone (901) 837-6801

2996 Kate Bond Rd
Ste 207
Bartlett, TN 38133
Phone (901) 379-0532

1995 Highway 51 S
Covington, TN 38019
Phone (901) 476-2621

1700 Woodlawn Ave
Dyersburg, TN 38024
Phone (731) 286-1115

7205 Wolf River Blvd
Ste 100
Memphis, TN 38138
Phone (901) 507-9466

965 Ridge Lake Blvd
Ste 103
Memphis, TN 38120
Phone (901) 227-3221

6286 Briarcrest Ave
Ste 308
Memphis, TN 38120
Phone (901) 680-5190

8970 Winchester Rd
Memphis, TN 38125
Phone (901) 794-5806

1109 E Reelfoot Ave
Ste G
Union City, TN 38261
Phone (731) 884-1720

1109 E Reelfoot Ave
Ste F
Union City, TN 38261
Phone (731) 884-1412

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

1109 E Reelfoot Ave
Ste K
Union City, TN 38261
Phone (731) 599-9909

Interoperability endpoints

  • Direct secure messaging: aharris40285@direct.bmhcc.org

Organizations & group practices 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1124034541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 405827",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303845800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 E REELFOOT AVE STE F",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615867",
            "telephone_number": "731-884-1412",
            "fax_number": "731-884-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "0103714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1750514410",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.