Individual provider Active NPI

Wendy M Harris, FNP-C

  • Family Nurse Practitioner
  • Defuniak Springs, FL
National Provider Identifier
1336344142
Registry record updated Aug 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11047234 Issued in FL
Practice address
1045 US Highway 331 S Ste D
Defuniak Springs, FL 32435-3379
Phone
(850) 892-3366
Fax
(833) 451-2227
NPI assigned
Jun 20, 2007
Last updated
Aug 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11047234 FL Primary

Addresses

Primary practice location

1045 US Highway 331 S Ste D
Defuniak Springs, FL 32435-3379

Mailing address

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8150

Other identifiers 2

IdentifierTypeStateIssuer
F21WHOtherFLFL BLUE
131296900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20080213000591 GA Practitioner - Nurse Practitioner 1951484997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707

1507 Royce Dr
Locust Grove, GA 30248-2478

222 Berkeley St
Suite 2000
Boston, MA 02116-3765

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN113723 NPGAMDNurse Practitioner
RN113723GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brightmoor Hospice, LLC CurrentSince Jan 13, 2025 Accepting new patients
White-Wilson Medical Center PA CurrentSince Aug 3, 2026 Accepting new patients
Children 1St Pediatrics PastSince Jun 15, 2021 Accepting new patients
Children 1St Pediatrics PastSince Jun 15, 2021 Accepting new patients
Southern Crescent ENT, P.C. PastSince Sep 17, 2015 Accepting new patients

Locations

1045 US Highway 331 S
Ste D
Defuniak Springs, FL 32435
Phone (850) 892-3366

1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100

3247 Newnan Rd
Griffin, GA 30223
Phone (770) 467-9930

Interoperability endpoints

  • Direct secure messaging: wendy.harris@cpd.eclinicaldirectplus.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1336344142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8150",
            "fax_number": "850-863-4152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 US HIGHWAY 331 S STE D",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324353379",
            "telephone_number": "850-892-3366",
            "fax_number": "833-451-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WENDY",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11047234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "F21WH",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131296900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Defuniak Springs, FL

Sources for this page

Verify at the official NPI Registry.