Individual provider Active NPI

Nancy Lane Harris, NP

  • Adult Health Nurse Practitioner
  • Delray Beach, FL
National Provider Identifier
1336212380
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP 9162696 Issued in FL
Practice address
55 SE 2ND Ave
Delray Beach, FL 33444-3615
Phone
(561) 400-4118
NPI assigned
Nov 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2875 SC
Adult Health Nurse Practitioner 363LA2200X ARNP 9162696 FL Primary

Addresses

Primary practice location

55 SE 2ND Ave
Delray Beach, FL 33444-3615

Mailing address

909 SE 5TH Ave
Suite 201
Delray Beach, FL 33483-5172
Phone (561) 900-2498

Other identifiers 4

IdentifierTypeStateIssuer
7004494MedicaidNC
NP0019MedicaidSC
P00691785OtherSCRR MEDICARE
196631OtherSCMEDCOST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2875SCMDPhysician Assistant
ARNP 9162696FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
QSS-Southeast Clinical Services LLC Past Accepting new patients
Qualified Surgical Services PLLC Past Accepting new patients
NLH Bocamed Inc PastSince Jan 8, 2014 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1336212380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 SE 5TH AVE",
            "address_2": "SUITE 201",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334835172",
            "telephone_number": "561-900-2498",
            "fax_number": "888-972-4762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SE 2ND AVE",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334443615",
            "telephone_number": "561-400-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "NANCY",
        "middle_name": "LANE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "2875",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 9162696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004494",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0019",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00691785",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "196631",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.