Active NPI
Tamara Marie Harris, PA-C
- Physician Assistant
- Lilburn, GA
National Provider Identifier
1134556848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3876
- Practice address
- 5155 Shadow Path LN SW
Lilburn, GA 30047-7707 - Phone
- (770) 630-5041
- NPI assigned
- Sep 27, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3876 | GA | Primary |
Addresses
Primary practice location
5155 Shadow Path LN SW
Lilburn, GA 30047-7707
Mailing address
5155 Shadow Path LN SW
Lilburn, GA 30047-7707
Phone (770) 630-5041
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3876 | GA | MD | Physician Assistant |
Interoperability endpoints
- tamaraharris@rpgpc.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733270400000",
"number": "1134556848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5155 SHADOW PATH LN SW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300477707",
"telephone_number": "770-630-5041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5155 SHADOW PATH LN SW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300477707",
"telephone_number": "770-630-5041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "TAMARA",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-27",
"last_updated": "2024-12-04",
"certification_date": "2024-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "3876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lilburn, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.