Active NPI
Elizabeth Avis Harrison, MD
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1225216054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2009012114
- Practice address
- 4488 Forest Park Ave
Ste 230
Saint Louis, MO 63108-2283 - Phone
- (314) 535-7855
- Fax
- (314) 534-2803
- NPI assigned
- Feb 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 2009012114 | MO | |
| Pediatrics Physician | 208000000X | 2009012114 | MO | Primary |
Addresses
Primary practice location
4488 Forest Park Ave
Ste 230
Saint Louis, MO 63108-2283
Mailing address
PO Box 7412021
Chicago, IL 60674-2021
Phone (314) 535-7855
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204207906 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744934400000",
"number": "1225216054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7412021",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606742021",
"telephone_number": "314-535-7855",
"fax_number": "314-534-2803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4488 FOREST PARK AVE",
"address_2": "STE 230",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082283",
"telephone_number": "314-535-7855",
"fax_number": "314-534-2803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "ELIZABETH",
"middle_name": "AVIS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-04",
"last_updated": "2025-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "MO",
"license": "2009012114",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MO",
"license": "2009012114",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204207906",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"affiliationName": "Washington University",
"address_1": "4488 Forest Park Ave",
"address_2": "STE 230",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631082283",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.