Individual provider Active NPI

Brandi Marie Harris

  • Physician Assistant
  • Bountiful, UT
National Provider Identifier
1134629181
Registry record updated Mar 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1551 Renaissance Towne Dr
Bountiful, UT 84010-7667
Phone
(801) 295-7200
NPI assigned
Feb 16, 2018
Last updated
Mar 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1551 Renaissance Towne Dr
Bountiful, UT 84010-7667

Mailing address

1551 Renaissance Towne Dr Ste 400
Bountiful, UT 84010-7676
Phone (801) 295-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180412000856 CA Practitioner - Physician Assistant 7810250487 Reassigns benefits to 1 organization
I20211018002641 UT Practitioner - Physician Assistant 7810250487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Orthopaedics LLCGroup PAC ID 7113282179, 26 clinicians

Practice addresses (Care Compare)

1551 Renaissance Town Dr
Suite 400
Bountiful, UT 84010-7676

1551 Renaissance Towne Dr
Suite 500
Bountiful, UT 84010-7678
Phone (801) 295-7200

201 W Layton Pkwy
Suite 400
Layton, UT 84041-3692
Phone (801) 295-7200

5405 S 500
Suite 204
Ogden, UT 84405-6957
Phone (801) 295-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Mar 9, 2018 Accepting new patients
Cep America-California CurrentSince Mar 9, 2018 Accepting new patients

Locations

500 W Hospital Rd
French Camp, CA 95231
Phone (209) 468-6000

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Interoperability endpoints

  • Direct secure messaging: brandi.harris.1@27251.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710633600000",
    "number": "1134629181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 400",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107676",
            "telephone_number": "801-295-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107667",
            "telephone_number": "801-295-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "BRANDI",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-16",
        "last_updated": "2024-03-17",
        "certification_date": "2024-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

Verify at the official NPI Registry.