Individual provider Active NPI

Chansila Ork Harris, NP

  • Family Nurse Practitioner
  • Glen Allen, VA
National Provider Identifier
1194347971
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024179325 Issued in VA
Practice address
4050 Innslake Dr Ste 360
Glen Allen, VA 23060-3323
Phone
(804) 273-0344
NPI assigned
May 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024179325 VA
Family Nurse Practitioner 363LF0000X 0024179325 VA Primary

Addresses

Primary practice location

4050 Innslake Dr Ste 360
Glen Allen, VA 23060-3323

Mailing address

4050 Innslake Dr Ste 360
Glen Allen, VA 23060-3323
Phone (804) 273-0344

Other practice location 1

3514 W Cary St
Richmond, VA 23221-2729
Phone (804) 355-8533

Other practice location 2

6100 Arlington Blvd
Falls Church, VA 22044-2901
Phone (401) 487-5117

Other practice location 3

11271 Nuckols Rd
Glen Allen, VA 23059-5502
Phone (804) 217-8881

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024179325VAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1194347971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DR STE 360",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603323",
            "telephone_number": "804-273-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DR STE 360",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603323",
            "telephone_number": "804-273-0344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3514 W Cary St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232212729",
            "country_code": "US",
            "telephone_number": "804-355-8533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6100 Arlington Blvd",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220442901",
            "country_code": "US",
            "telephone_number": "401-487-5117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11271 Nuckols Rd",
            "address_purpose": "LOCATION",
            "city": "Glen Allen",
            "state": "VA",
            "postal_code": "230595502",
            "country_code": "US",
            "telephone_number": "804-217-8881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHANSILA",
        "middle_name": "ORK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024179325",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024179325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.