Active NPI
Kyra Loreen Harrison, PA
- Physician Assistant
- North Hollywood, CA
National Provider Identifier
1316653702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 11650 Riverside Dr Ste 11
North Hollywood, CA 91602-1095 - Phone
- (310) 954-1450
- NPI assigned
- Jan 27, 2023
- Sex
- Female
- 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 | Primary |
Addresses
Primary practice location
11650 Riverside Dr Ste 11
North Hollywood, CA 91602-1095
Mailing address
1718 N Las Palmas Ave Apt 234
Los Angeles, CA 90028-3815
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 29, 2026 through Apr 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- kyra.harrison.1@27211.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676073600000",
"number": "1316653702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1718 N LAS PALMAS AVE APT 234",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900283815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11650 RIVERSIDE DR STE 11",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916021095",
"telephone_number": "310-954-1450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRISON",
"first_name": "KYRA",
"middle_name": "LOREEN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-27",
"last_updated": "2023-02-11",
"certification_date": "2023-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.