Individual provider Active NPI

Katherine C Farrell Harris, R.D., C.D.N., C.D.E.

  • Registered Dietitian
  • New York, NY
National Provider Identifier
1265665616
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
005474 Issued in NY
Practice address
52 Duane St
New York, NY 10007-1207
Phone
(646) 680-4227
Fax
(516) 542-5556
NPI assigned
Sep 2, 2009
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 005474 NY Primary
Diabetes Educator Registered Nurse 163WD0400X 20510119 NY

Addresses

Primary practice location

52 Duane St
New York, NY 10007-1207

Mailing address

Advantagecare Physicians, PC
55 Water Street 2ND Floor Cred Dept
New York, NY 10041-0004
Phone (646) 680-2888

Other practice location 1

21 East 22nd Street
New York, NY 10010-9995
Phone (212) 460-7800

Other practice location 2

1050 Clove Road
Staten Island, NY 10301-3627
Phone (718) 816-6440

Other practice location 3

590 5th Ave
New York, NY 10036-4702
Phone (212) 582-7117

Other practice location 4

96-10 Metropolitan Ave
Forest Hills, NY 11375-6625
Phone (718) 459-0400

Other identifiers 2

IdentifierTypeStateIssuer
03459592MedicaidNY
000600027483OtherNYHEALTH PLUS

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

State licenses

LicenseStateTypeSpecialty
20510119NYMDDiabetes Educator Registered Nurse
005474NYMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1265665616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ADVANTAGECARE PHYSICIANS, PC",
            "address_2": "55 WATER STREET 2ND FLOOR CRED DEPT",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410004",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 DUANE ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100071207",
            "telephone_number": "646-680-4227",
            "fax_number": "516-542-5556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 East 22nd Street",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100109995",
            "country_code": "US",
            "telephone_number": "212-460-7800",
            "fax_number": "212-460-7877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Clove Road",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103013627",
            "country_code": "US",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "590 5th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100364702",
            "country_code": "US",
            "telephone_number": "212-582-7117",
            "fax_number": "212-484-3530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "96-10 Metropolitan Ave",
            "address_purpose": "LOCATION",
            "city": "Forest Hills",
            "state": "NY",
            "postal_code": "113756625",
            "country_code": "US",
            "telephone_number": "718-459-0400",
            "fax_number": "718-670-6479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRELL HARRIS",
        "first_name": "KATHERINE",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "R.D., C.D.N., C.D.E.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "005474",
            "primary": true
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NY",
            "license": "20510119",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03459592",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "000600027483",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.