Mardis H Harrell, CRNA

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

ARNP 2135062 Issued in FL

Practice address

928 Mar Walt Dr
Suite 201
Fort Walton Beach, FL 32547-6706

Phone

(850) 862-4377

Fax

(850) 862-6015

NPI assigned

Aug 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

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.

• Francis C F Decroos MD PA

  • Anesthesiology Physician
  • Fort Walton Beach, FL
  • NPI 1497788251
  NPD (past)
• Northwest Florida Multispecialty Physicians LLC

  • Neurological Surgery Physician
  • Fort Walton Beach, FL
  • NPI 1790912269
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1316949126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 CLIFFORD DR",
            "city": "SHALIMAR",
            "state": "FL",
            "postal_code": "325791251",
            "telephone_number": "850-651-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 MAR WALT DR",
            "address_2": "SUITE 201",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476706",
            "telephone_number": "850-862-4377",
            "fax_number": "850-862-6015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRELL",
        "first_name": "MARDIS",
        "middle_name": "H",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "ARNP 2135062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lee Hanson, M.D.
• John Jared Harden, CRNA
• Megan Hardy, PA-C
• Lakysha N Harper, CCMA, CPT
• Kelli Jean Harrell, LMHC
• Alec Thomas Harrington, DO
• Andrea Harris
• Kylie Harris
• Lindsay Harris, APRN
• Precious Harris, OT

• Registered Nurse in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.