Kevin Russell Harris, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S813 TA107 Issued in AL

Practice address

2620 Centron Dr SW
Decatur, AL 35603-2500

Phone

(256) 350-6655

Fax

(256) 350-2548

NPI assigned

Feb 2, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University Alabama Birmingham - School of Optometry, 1995

Medicare assignment

May accept Medicare assignment

Group practices

Marx Optical IncGroup PAC ID 4082733258, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Marx Optical Inc

  • Eyewear Supplier
  • Decatur, AL
  • NPI 1942346101
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194863183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 BYRD RD",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356405907",
            "telephone_number": "256-751-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 CENTRON DR SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356032500",
            "telephone_number": "256-350-6655",
            "fax_number": "256-350-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KEVIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S813 TA107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000-79209",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rodney Tyler Harney, M.D.
• Rodney Wayne Harney, M.D.
• Cynthia Wade Harper
• Blake Christian Harris, DO
• Jeffery Willard Harris, CRNP
• Patrick Scott Harris, M.D.
• Robert Franklin Harris
• Steven Blake Harris, RPH
• Janis Lynn Hart, LICSW
• Melissa Hart, LMT

• Optometrist in Decatur, AL
• Providers in Decatur, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.