Mary Emily Moran Harris, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4195 Issued in SC

Practice address

425 North Cedar St
Summerville, SC 29483-6407

Phone

(843) 476-4702

Fax

(843) 476-4290

NPI assigned

Aug 17, 2020

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Southern Coast Spine and Pain Specialists LLC

  • Pain Medicine (Anesthesiology) Physician
  • Beaufort, SC
  • NPI 1508518069
  Medicare reassignment

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1376154997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 RIBAUT RD STE 30",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299025447",
            "telephone_number": "843-476-4702",
            "fax_number": "843-476-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 NORTH CEDAR ST",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294836407",
            "telephone_number": "843-476-4702",
            "fax_number": "843-476-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARY EMILY",
        "middle_name": "MORAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-17",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4956PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harris Teeter LLC
• Brandy Harris, DNP, CPNP-PC
• Craig Dyer Harris, MD
• Janet S Harris
• Kellie Harris, PTA
• Heather Greenberg Harrison, PA-C
• Harry Cotler LLC
• Harth Place Family Medicine
• Elizabeth Butler Hartjes, PHARMD
• Julia Christine Hartman

• Physician Assistant in Summerville, SC
• Providers in Summerville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.