Individual provider Active NPI

Gerald Harris Jr.

  • Home Modifications Contractor
  • Chesapeake, VA
National Provider Identifier
1134439359
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
License
2705-048516A Issued in VA
Practice address
1327 Poindexter St
Chesapeake, VA 23324-2428
Phone
(757) 545-4551
Fax
(757) 545-4311
NPI assigned
Oct 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications Contractor 171WH0202X 2705-048516A VA Primary

Addresses

Primary practice location

1327 Poindexter St
Chesapeake, VA 23324-2428

Mailing address

1327 Poindexter St
Chesapeake, VA 23324-2428
Phone (757) 545-4551

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2705-048516AVAMDHome Modifications Contractor

NPI Registry JSON

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1134439359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 POINDEXTER ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242428",
            "telephone_number": "757-545-4551",
            "fax_number": "757-545-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 POINDEXTER ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242428",
            "telephone_number": "757-545-4551",
            "fax_number": "757-545-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GERALD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "VA",
            "license": "2705-048516A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.