Individual provider Active NPI

Melissa Ann Harris, NP

  • Family Nurse Practitioner
  • Centreville, MD
National Provider Identifier
1366311631
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R123612 Issued in MD
Practice address
202 Coursevall Dr Ste 101
Centreville, MD 21617-2805
Phone
(410) 758-3303
NPI assigned
Nov 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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 R123612 MD Primary

Addresses

Primary practice location

202 Coursevall Dr Ste 101
Centreville, MD 21617-2805

Mailing address

121 Wilson Clark LN
Centreville, MD 21617-1928
Phone (410) 924-9992

Other practice location 1

28438 Marlboro Ave
Easton, MD 21601-2732
Phone (410) 820-7270

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260316003864 MD Practitioner - Nurse Practitioner 1759864952 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Luminis Health Medical Group, LLCGroup PAC ID 2860447315, 540 clinicians

Practice addresses (Care Compare)

202 Coursevall Dr
Centreville, MD 21617-2804
Phone (410) 758-3303

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R123612MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Luminis Health Medical Group, LLC CurrentSince Mar 1, 2026 Accepting new patients
Luminis Health Medical Group, LLC CurrentSince Mar 1, 2026 Accepting new patients

Locations

202 Coursevall Dr
Ste 101
Centreville, MD 21617
Phone (410) 758-3303

202 Coursevall Dr
Centreville, MD 21617
Phone (410) 758-3303

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1762214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1366311631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WILSON CLARK LN",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216171928",
            "telephone_number": "410-924-9992",
            "fax_number": "410-924-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 COURSEVALL DR STE 101",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216172805",
            "telephone_number": "410-758-3303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28438 Marlboro Ave",
            "address_purpose": "LOCATION",
            "city": "Easton",
            "state": "MD",
            "postal_code": "216012732",
            "country_code": "US",
            "telephone_number": "410-820-7270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-04",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R123612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

Verify at the official NPI Registry.