Carly Elaine Harris

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

AC003339 Issued in MD

Practice address

4494 North Palmer Road
Bethesda, MD 20889-0001

Phone

(804) 317-4541

NPI assigned

Oct 7, 2020

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

Enrolled in MD

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1326645821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 LEBANON CHURCH RD",
            "city": "DUNNSVILLE",
            "state": "VA",
            "postal_code": "224542228",
            "telephone_number": "804-317-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 NORTH PALMER ROAD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "804-317-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CARLY",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "MD",
            "license": "AC003339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Bridget Harrington, DDS
• Harris Teeter LLC
• Harris Teeter, LLC
• Ayden L.W Harris, DO
• Bridget Harris
• Dinsley Nichol Harris, IDC
• Krystle Yvonne Harris, PA-C
• Sharon Hobbs Harris, O.T.R./L
• Twili Harris
• Mitchell Harrison, MD

• Critical Care Pediatric Nurse Practitioner in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Critical Care Pediatric Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.