Angela Jean Harris, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5601006820 Issued in MI

Practice address

3133 S Telegraph Rd
Dearborn, MI 48124-3472

Phone

(313) 565-6566

NPI assigned

Sep 24, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DCBJAD/Endpoint/DCBJAD

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1144656935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 S TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243472",
            "telephone_number": "313-565-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 S TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243472",
            "telephone_number": "313-565-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANGELA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakota Smith Harrell
• Jazmyne Harrell
• Alana Harris
• Alyssa L Harris
• Amber Rae Harris, RBT
• Ayanna E Harris, MA, LLPC
• Charles Harris III
• Cheyenne Harris
• Colby Harris
• Damita Jo Harris, PROF. COUNSELOR LTD

• Medical Physician Assistant in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Medical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.

Verify at the official NPI Registry.