Melanie R. Harrison, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1494 Issued in TN

Practice address

1 Professional Park Dr
Suite 21
Johnson City, TN 37604-6587

Phone

(423) 946-4163

Fax

(423) 232-6903

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Legacy Vein Center PLLC

  • Vascular Surgery Physician
  • Johnson City, TN
  • NPI 1477972933
  Medicare reassignment
• Appalachian Emergency Physicians

  • Emergency Medicine Physician
  • Erwin, TN
  • NPI 1932451291
  NPD
• Legacy Vein Center PLLC

  • Durable Medical Equipment & Medical Supplies
  • Sevierville, TN
  • NPI 1770158859
  NPD
• Emergency Care Physicians, Inc.

  • Emergency Medicine Physician
  • Johnson City, TN
  • NPI 1669410304
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382572800000",
    "number": "1326178138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL PARK DR",
            "address_2": "SUITE 21",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046587",
            "telephone_number": "423-946-4163",
            "fax_number": "423-232-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PROFESSIONAL PARK DR",
            "address_2": "SUITE 21",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046587",
            "telephone_number": "423-946-4163",
            "fax_number": "423-232-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "MELANIE",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2013-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "1494",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "1494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3665068",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maggie Harris
• Steven A Harris, LPC, MHSP
• Colleen Gloria Harrison, OTR
• Ellen Bernice Harrison, LPN
• Jordan Daniel Harrison, OD
• Katherine A Hart, CRNA
• Kenneth David Hart Jr., ATC
• Sara Hart
• Caitlyn Harter, ATC
• James David Hartigan, M.ED.

• Surgical Physician Assistant in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Surgical Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.