Individual provider Active NPI

Kendall Harris, DO

  • Family Medicine Physician
  • Tahlequah, OK
National Provider Identifier
1184253403
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7273 Issued in OK
Practice address
100 Bliss Ave
Tahlequah, OK 74464
Phone
(918) 458-3100
NPI assigned
Apr 7, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7273 OK Primary

Addresses

Primary practice location

100 Bliss Ave
Tahlequah, OK 74464

Mailing address

100 Bliss Ave
Tahlequah, OK 74464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813000952 TX Practitioner - Osteopathic Manipulative Medicine 2961806872 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Oklahoma State University College of Osteopathic Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherokee NationGroup PAC ID 5799698742, 446 clinicians

Practice addresses (Care Compare)

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3100

Hospital & facility affiliations

  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7273OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Past Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

471688 Highway 51
Stilwell, OK 74960

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1184253403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74464",
            "telephone_number": "918-458-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KENDALL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.