Charles Eugene Harris, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36-620 Issued in MS

Practice address

5427-A Gex Rd
Diamondhead, MS 39525

Phone

(228) 255-4832

NPI assigned

May 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Charles Harris PHD PLLC

  • Skilled Nursing Facility
  • Ocean Springs, MS
  • NPI 1588052096
  Authorized official Same address or phone
• Nursing Home Psychological Services of Mississippi, Inc.

  • Psychologist
  • Jackson, MS
  • NPI 1184725533
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346461423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 NELSON DR",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643032",
            "telephone_number": "228-875-7648",
            "fax_number": "228-872-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5427-A GEX RD",
            "city": "DIAMONDHEAD",
            "state": "MS",
            "postal_code": "39525",
            "telephone_number": "228-255-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHARLES",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MS",
            "license": "36-620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04804801",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hancock Medical Health Services
• Hancock Medical Health Services, Inc. (Hancock Medical Orthopedic)
• Hancock Medical Health Services, Inc. (Hancock Family Medicine)
• Hancock Medical Health Services, Inc. (Hancock Medical Womens Services)
• Hancock Medical Health Services, Inc. (Diamondmed Urgent Care)
• Preethi S Harrison, PA-C
• Allison Kae Hennessey
• Desmond Wayne Hoda, D.C.
• John Cameron Hodge, D.O.
• Kenneth Edward Hultman

• Clinical Psychologist in Diamondhead, MS
• Providers in Diamondhead, MS by specialty
• Clinical Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.