Individual provider Active NPI

Johnnie Rebbecca Harris, PHD, MSN/MHA, RN

  • Family Nurse Practitioner
  • Haskell, TX
National Provider Identifier
1164319299
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
660676 Issued in TX
Practice address
1417 N 1St St
Haskell, TX 79521-5435
Phone
(940) 228-0612
NPI assigned
Jun 20, 2025
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 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 660676 TX Primary

Addresses

Primary practice location

1417 N 1St St
Haskell, TX 79521-5435

Mailing address

2709 County Road 16500
Deport, TX 75435-5217
Phone (903) 401-9123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
660676TXMDWound Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Western Wellness & Aesthetics LLC Wound Care CurrentSince Jun 29, 2025 Accepting new patients

Locations

4510 Stonewall St
Greenville, TX 75401
Phone (903) 401-9123

Organizations & group practices 1

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": "1750377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1164319299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 COUNTY ROAD 16500",
            "city": "DEPORT",
            "state": "TX",
            "postal_code": "754355217",
            "telephone_number": "903-401-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N 1ST ST",
            "city": "HASKELL",
            "state": "TX",
            "postal_code": "795215435",
            "telephone_number": "940-228-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOHNNIE",
        "middle_name": "REBBECCA",
        "name_prefix": "Dr.",
        "credential": "PHD, MSN/MHA, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-20",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "660676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haskell, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.