Individual provider Active NPI

Joe Allen Harris, MD

  • Psychiatry Physician
  • Hattiesburg, MS
National Provider Identifier
1275576233
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
17029 Issued in MS
Practice address
1 Lincoln Parkway
Suite 202
Hattiesburg, MS 39402
Phone
(601) 288-8050
NPI assigned
Jun 14, 2006
Last updated
Dec 6, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 17029 MS Primary

Addresses

Primary practice location

1 Lincoln Parkway
Suite 202
Hattiesburg, MS 39402

Mailing address

1 Lincoln Parkway
Suite 202
Hattiesburg, MS 39402
Phone (601) 288-8050

Other practice location 1

Wesley Physician Services, LLC
5001 Hardy Street
Hattiesburg, MS 39402-1308
Phone (601) 268-8029

Other identifiers 3

IdentifierTypeStateIssuer
009933437MedicaidAL
00123351MedicaidMS
260048290OtherMSMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20080503000001 MS Practitioner - Psychiatry 0244319135 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17029MSMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wesley Physician Services LLC CurrentSince Jun 3, 2018 Accepting new patients

Locations

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1930/brand/2/csg/102/fhir/r4

Organizations & group practices 1

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1275576233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PARKWAY",
            "address_2": "SUITE 202",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-288-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LINCOLN PARKWAY",
            "address_2": "SUITE 202",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "39402",
            "telephone_number": "601-288-8050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Wesley Physician Services, LLC",
            "address_2": "5001 Hardy Street",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021308",
            "country_code": "US",
            "telephone_number": "601-268-8029",
            "fax_number": "601-296-3385",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "17029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009933437",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00123351",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "260048290",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.