Individual provider Active NPI

Ebony J'Niya Harris, FNP-BC

  • Family Nurse Practitioner
  • Tupelo, MS
National Provider Identifier
1144107145
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
907699 Issued in MS
Practice address
5357 Cliff Gookin Blvd
Tupelo, MS 38801-7085
Phone
(662) 871-1573
NPI assigned
Aug 20, 2025
Last updated
Oct 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 907699 MS Primary

Addresses

Primary practice location

5357 Cliff Gookin Blvd
Tupelo, MS 38801-7085

Mailing address

2690 McCullough Blvd Apt 328
Belden, MS 38826-9013
Phone (662) 295-6936

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20260113001885 MS Practitioner - Nurse Practitioner 8123504842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2690 McCullough Blvd
Apt 328
Belden, MS 38826-9003

501 S Chestnut St
Aberdeen, MS 39730-3336

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
907699MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Aberdeen Health Clinic Inc CurrentSince Dec 7, 2025 Accepting new patients

Locations

501 S Chestnut St
Aberdeen, MS 39730
Phone (662) 369-6110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19804/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791504000000",
    "number": "1144107145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 MCCULLOUGH BLVD APT 328",
            "city": "BELDEN",
            "state": "MS",
            "postal_code": "388269013",
            "telephone_number": "662-295-6936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5357 CLIFF GOOKIN BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388017085",
            "telephone_number": "662-871-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "EBONY",
        "middle_name": "J'NIYA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.