Martha A Harris, RN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

33592 Issued in MS

Practice address

934 West Dr
Laurel, MS 39440-4702

Phone

(601) 426-7520

Fax

(604) 428-5790

NPI assigned

Mar 11, 2021

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

Credentials

Registered Nurse

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.

• Region 12 Commission on Mental Health & Retardation Pine Belt Men

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hattiesburg, MS
  • NPI 1982610572
  NPD (past)
• Region XII Commission

  • General Practice Physician
  • Laurel, MS
  • NPI 1467767988
  NPD (past)

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1336724384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18679",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394048679",
            "telephone_number": "601-705-1901",
            "fax_number": "601-705-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 WEST DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404702",
            "telephone_number": "601-426-7520",
            "fax_number": "604-428-5790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARTHA",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "33592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Harper, CRISIS SERVICES
• Jillian Francelia Harper, LMSW
• Mary Harper
• William Andrew Harrelson
• Chadwick J. Harris, DMD
• John Hassell, MD
• Jennifer Hathorn, IDD WAIVER SERVICES
• Hattiesburg Clinic PA
• Hattiesburg Clinic PA
• Hattiesburg Clinic PA

• All providers in Laurel, MS
• Licensed Practical Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.