Active NPI
Joseph Michael Harris Jr., PT
- Physical Therapist
- Leitchfield, KY
National Provider Identifier
1184664096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 003064
- 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, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000179577 | Other | KY | ANTHEM BC/BS |
| 8700022000 | Medicaid | KY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003064 | KY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Physical Therapy & Fitness, PSC | Physical Therapist | Past | 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.
-
- Specialist
- Leitchfield, KY
- NPI 1366484701
-
dba Elite Physical Therapy
- Specialist
- Hardinsburg, KY
- NPI 1639294481
Physical Therapist
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.