Jack A Harris, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

29879 Issued in GA

Practice address

274 Big a Road
Toccoa, GA 30577-6002

Phone

(706) 886-0421

Fax

(706) 297-7617

NPI assigned

Aug 24, 2005

Last updated

Jun 13, 2013By 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 GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Toccoa Clinic Medical Associates, LLP

  • Multi-Specialty Clinic/Center
  • Toccoa, GA
  • NPI 1609896885
  Medicare reassignment NPD

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1245223361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776002",
            "telephone_number": "706-886-0421",
            "fax_number": "706-297-7617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776002",
            "telephone_number": "706-886-0421",
            "fax_number": "706-297-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "29879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335410959A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Hammett, MD
• Myrna Hammond, CPNP
• Brian Paul Hamon, SA-C, OA-C
• Jeanilee Hope Harbin
• Jennifer Lynn Harper, TH.D., CRS, PT
• Harry C McDonald, M.D.
• Kyler Gator Hazelett, PHARMD
• Lori Heffer, LCSW
• Cynthia Joye Hendrix, PHARMD
• Tammy Henson, PMHNP

• Ophthalmology Physician in Toccoa, GA
• Providers in Toccoa, GA by specialty
• Ophthalmology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.