Kenneth Wayne Harris, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A-45727 Issued in CA

Practice address

300 S Nevada Ave
Montrose, CO 81401-4273

Phone

(970) 249-7751

Fax

(970) 249-5029

NPI assigned

Feb 14, 2006

Last updated

Sep 24, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL, CO, CA3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Kuldip Gill M D P C

  • Internal Medicine Physician
  • Grass Valley, CA
  • NPI 1932397601
  Medicare reassignment NPD
• Metro Memphis Medical Specialist, Inc.

  • Ph.D. Medical Genetics
  • Memphis, TN
  • NPI 1316961931
  NPD (past) Authorized official
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Wiregrass Clinic LLC

  • Neurological Surgery Physician
  • Dothan, AL
  • NPI 1558657890

  Internal Medicine

  NPD
• Goodlife Medical Center, PLLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1811041668
  NPD (past)
• Quality Health PLLC

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1851482426
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1184698516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 PELLO LN",
            "city": "NEVADA CITY",
            "state": "CA",
            "postal_code": "959598337",
            "telephone_number": "901-229-1609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S NEVADA AVE",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014273",
            "telephone_number": "970-249-7751",
            "fax_number": "970-249-5029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 Pello Ln",
            "address_purpose": "LOCATION",
            "city": "Nevada City",
            "state": "CA",
            "postal_code": "959598337",
            "country_code": "US",
            "telephone_number": "901-229-1609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2431 West Main St.",
            "address_2": "Suite 1102",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "36301",
            "country_code": "US",
            "telephone_number": "334-699-5780",
            "fax_number": "334-699-5786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KENNETH",
        "middle_name": "WAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "CDRH.0059064",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A-45727",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD13956",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-11971",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60906292",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3096568",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles E Harper, MD
• Frances L Harper
• Jessica Maria Harrell, FNP-C
• Liam David Harrell, RN
• Alison Harris, PHD
• Penelope Harris, LPC
• Carol R Harrold, MD
• Jerilynn Hart, RD
• Michelle Marie Hart, AGACNP-BC
• Hartman Brothers Inc

• Internal Medicine Physician in Montrose, CO
• Providers in Montrose, CO by specialty
• Internal Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.