Active NPI
Staci Sithembile Harris, NP
- Nurse Practitioner
- Charlotte, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5009104
- Practice address
- 108 Providence Rd
Charlotte, NC 28207-1218 - Phone
- (704) 287-8604
- NPI assigned
- Oct 4, 2016
- Last updated
- Oct 31, 2025
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5009104 | NC | Primary |
| Adult Health Nurse Practitioner | 363LA2200X | 5009104 | NC | |
| Primary Care Nurse Practitioner | 363LP2300X | 20490 | SC |
Addresses
Primary practice location
108 Providence Rd
Charlotte, NC 28207-1218
Mailing address
PO Box 60447
Charlotte, NC 28260-0447
Other practice location 1
2550 S 41st St
Wilmington, NC 28403-5519
Phone (704) 695-1421
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10810 Mallard Creek Rd
Charlotte, NC 28262-9786
Phone (704) 510-8000
119 W Wade St
Wadesboro, NC 28170-2136
Phone (704) 694-5992
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5009104 | NC | MD | Adult Health Nurse Practitioner |
| 20490 | SC | MD | Primary Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Current | Accepting new patients | |
| Liberty Healthcare Group, LLC | Current | Accepting new patients | |
| Liberty Healthcare Group LLC | Current | Accepting new patients | |
| Novant Health Medical Group, LLC | Past | Accepting new patients |
Locations
10011 Providence Rd W
Charlotte, NC 28277
Phone (980) 245-8500
108 Providence Rd
Charlotte, NC 28207
Phone (336) 277-3431
10810 Mallard Creek Rd
Charlotte, NC 28262
Phone (704) 510-8000
2700 Royal Commons Ln
Matthews, NC 28105
Phone (704) 636-7181
5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441
119 W Wade St
Wadesboro, NC 28170
Phone (704) 694-5992
1402 Pinckney St
Whiteville, NC 28472
Phone (910) 642-4245
44 McNeill Plz
Whiteville, NC 28472
Phone (910) 642-0224
2334 41st St
Wilmington, NC 28403
Phone (910) 815-3122
2550 41st St
Wilmington, NC 28403
Phone (910) 251-8111
420 Eastwood Rd
Ste 102
Wilmington, NC 28403
Phone (910) 251-8111
2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300
Interoperability endpoints
- sharris243448@direct.novanthealth.org
Organizations & group practices 6
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.
-
dba Liberty Home Care, LLC
- Case Management Agency
- Wilmington, NC
- NPI 1629217856
-
dba Novant Health Pediatric Neurology & Sleep
- Neurology with Special Qualifications in Child Neurology Physician
- Charlotte, NC
- NPI 1366409492
-
dba Golden Years Nursing Center
- Skilled Nursing Facility
- Falcon, NC
- NPI 1912040379
-
dba NHMG Primary Care Clinics
- Internal Medicine Physician
- Charlotte, NC
- NPI 1134841802
-
dba Novant Health Elizabeth OB/GYN
- Obstetrics & Gynecology Physician
- Matthews, NC
- NPI 1386506137
-
dba Novant Health Northlake Dermatology
- Dermatopathology Physician
- Huntersville, NC
- NPI 1396751640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761868800000",
"number": "1134679012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60447",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282600447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 PROVIDENCE RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282071218",
"telephone_number": "704-287-8604"
}
],
"practiceLocations": [
{
"address_1": "2550 S 41st St",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284035519",
"country_code": "US",
"telephone_number": "704-695-1421",
"fax_number": "704-694-7748",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARRIS",
"first_name": "STACI",
"middle_name": "SITHEMBILE",
"name_prefix": "Mrs.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-04",
"last_updated": "2025-10-31",
"certification_date": "2025-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NC",
"license": "5009104",
"primary": true
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NC",
"license": "5009104",
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "SC",
"license": "20490",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000000",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.