NPIMap

Individual provider Active NPI

Michael R. Harrison, M.D.

  • Cardiovascular Disease Physician
  • Evansville, IN
National Provider Identifier
1245219161
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
01039589 Issued in IN
Practice address
520 Mary St
Suite 230
Evansville, IN 47710-1677
Phone
(812) 452-3400
Fax
(812) 452-3403
NPI assigned
Jan 10, 2006
Last updated
Jul 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 01039589 IN Primary

Addresses

Primary practice location

520 Mary St
Suite 230
Evansville, IN 47710-1677

Mailing address

520 Mary St
Suite 230
Evansville, IN 47710-1677
Phone (812) 452-3400

Other identifiers 1

IdentifierTypeStateIssuer
100343880MedicaidIN

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

State licenses

LicenseStateTypeSpecialty
01039589INMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients
The Heart Hospital at Deaconess Gateway, LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1245219161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MARY ST",
            "address_2": "SUITE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101677",
            "telephone_number": "812-452-3400",
            "fax_number": "812-452-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MARY ST",
            "address_2": "SUITE 230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101677",
            "telephone_number": "812-452-3400",
            "fax_number": "812-452-3403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MICHAEL",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "01039589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100343880",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.