Active NPI
Michael Shane Harris, PA-C
- Physician Assistant
- Alexandria, LA
National Provider Identifier
1275847394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.200360
- Practice address
- 3330 Masonic Dr
Alexandria, LA 71301-3841 - Phone
- (318) 449-2415
- NPI assigned
- Jul 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.200360 | LA | Primary |
Addresses
Primary practice location
3330 Masonic Dr
Alexandria, LA 71301-3841
Mailing address
919 Hidden RDG
Irving, TX 75038-3813
Phone (469) 282-2711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2353454 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3330 Masonic Dr
Alexandria, LA 71301-3841
Phone (318) 487-1122
Hospital & facility affiliations
- Christus St Frances Cabrini Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.200360 | LA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients |
Locations
3330 Masonic Dr
Alexandria, LA 71301
Phone (318) 448-6917
1453 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 681-4138
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Care Medicine (Internal Medicine) Physician
- Alexandria, LA
- NPI 1225840044
-
- Internal Medicine Physician
- Alexandria, LA
- NPI 1417738675
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
Hospital & facility affiliations 18
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1023139458
Hospital
-
- Student Health Clinic/Center
- Pineville, LA
- NPI 1093836421
Hospital
-
- Student Health Clinic/Center
- Provencal, LA
- NPI 1164687307
Hospital
-
- Student Health Clinic/Center
- Natchitoches, LA
- NPI 1356462782
Hospital
-
- Student Health Clinic/Center
- Marthaville, LA
- NPI 1609031962
Hospital
-
- General Acute Care Hospital
- Alexandria, LA
- NPI 1639160799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486512000000",
"number": "1275847394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "919 HIDDEN RDG",
"city": "IRVING",
"state": "TX",
"postal_code": "750383813",
"telephone_number": "469-282-2711",
"fax_number": "469-282-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 MASONIC DR",
"city": "ALEXANDRIA",
"state": "LA",
"postal_code": "713013841",
"telephone_number": "318-449-2415"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "MICHAEL",
"middle_name": "SHANE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-30",
"last_updated": "2017-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "LA",
"license": "PA.200360",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2353454",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.