Individual provider Active NPI

Clemmie Harris III, APRN,PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Newport News, VA
National Provider Identifier
1194534487
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024192000 Issued in VA
Practice address
732 Thimble Shoals Blvd Ste 202
Newport News, VA 23606-4262
Phone
(757) 223-7810
NPI assigned
Jan 2, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0024192000 VA Primary

Addresses

Primary practice location

732 Thimble Shoals Blvd Ste 202
Newport News, VA 23606-4262

Mailing address

732 Thimble Shoals Blvd Ste 202
Newport News, VA 23606-4262
Phone (757) 223-7810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251008002411 VA Practitioner - Nurse Practitioner 1759888423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

831 Bedford Ave
Suite 530
Brooklyn, NY 11205-2801

974 Willbrook Rd
Newport News, VA 23602-9101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024192000VAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Available Mental Health Services, LLC Psychiatric/Mental Health CurrentSince Jan 5, 2025 Accepting new patients
Rhodium Care Group Inc CurrentSince Jun 10, 2025 Accepting new patients

Locations

8830 Virginia St
Amelia Ct Hse, VA 23002
Phone (804) 561-5611

732 Thimble Shoals Blvd
Ste 202
Newport News, VA 23606
Phone (757) 223-7810

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1194534487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 THIMBLE SHOALS BLVD STE 202",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064262",
            "telephone_number": "757-223-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 THIMBLE SHOALS BLVD STE 202",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064262",
            "telephone_number": "757-223-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CLEMMIE",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "APRN,PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024192000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.