Active NPI
Timothy Brett Harris, PHD CCCSLP
- Speech-Language Pathologist
- Boone, NC
National Provider Identifier
1194749457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1747
- Practice address
- 400 University Hall Drive
Room 120
Boone, NC 28608-2041 - Phone
- (828) 262-2185
- Fax
- (828) 262-6766
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1747 | NC | Primary |
Addresses
Primary practice location
400 University Hall Drive
Room 120
Boone, NC 28608-2041
Mailing address
400 University Hall Drive
Room 120
Boone, NC 28608-2041
Phone (828) 262-2185
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40009 | Other | NC | BCBS OF NC |
| 7411018 | Medicaid | NC |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1747 | NC | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223596800000",
"number": "1194749457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 UNIVERSITY HALL DRIVE",
"address_2": "ROOM 120",
"city": "BOONE",
"state": "NC",
"postal_code": "286082041",
"telephone_number": "828-262-2185",
"fax_number": "828-262-6766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 UNIVERSITY HALL DRIVE",
"address_2": "ROOM 120",
"city": "BOONE",
"state": "NC",
"postal_code": "286082041",
"telephone_number": "828-262-2185",
"fax_number": "828-262-6766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "TIMOTHY",
"middle_name": "BRETT",
"name_prefix": "Dr.",
"credential": "PHD CCCSLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2008-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "1747",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "40009",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7411018",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.