Individual provider Active NPI

Joseph Michael Harris Jr., PT

  • Physical Therapist
  • Leitchfield, KY
National Provider Identifier
1184664096
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003064 Issued in KY
Practice address
201 South Main Street
Leitchfield, KY 42754
Phone
(270) 230-1729
Fax
(270) 230-1750
NPI assigned
Jun 8, 2006
Last updated
Nov 29, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 003064 KY Primary

Addresses

Primary practice location

201 South Main Street
Leitchfield, KY 42754

Mailing address

P.O. Box 26
Leitchfield, KY 42755
Phone (270) 230-1729

Other practice location 1

201 South Main Street
Leitchfield, KY 42754
Phone (270) 230-1729

Other practice location 2

201 South Main Street
Leitchfield, KY 42754
Phone (270) 230-1729

Other identifiers 2

IdentifierTypeStateIssuer
000000179577OtherKYANTHEM BC/BS
8700022000MedicaidKY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
003064KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Physical Therapy & Fitness, PSC Physical Therapist PastSince May 28, 2023 Accepting new patients

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543449600000",
    "number": "1184664096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 26",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "42755",
            "telephone_number": "270-230-1729",
            "fax_number": "270-230-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SOUTH MAIN STREET",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "42754",
            "telephone_number": "270-230-1729",
            "fax_number": "270-230-1750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 South Main Street",
            "address_purpose": "LOCATION",
            "city": "Leitchfield",
            "state": "KY",
            "postal_code": "42754",
            "country_code": "US",
            "telephone_number": "270-230-1729",
            "fax_number": "270-230-1750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 South Main Street",
            "address_purpose": "LOCATION",
            "city": "Leitchfield",
            "state": "KY",
            "postal_code": "42754",
            "country_code": "US",
            "telephone_number": "270-230-1729",
            "fax_number": "270-230-1750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2018-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "003064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000179577",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8700022000",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leitchfield, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.