Individual provider Active NPI

Anna Brooke Harris, PA-C

  • Physician Assistant
  • Monroe, LA
National Provider Identifier
1376949636
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200098 Issued in LA
Practice address
3513 Lake Desiard Dr
Monroe, LA 71201-2078
Phone
(318) 366-4379
NPI assigned
Nov 14, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200098 LA Primary

Addresses

Primary practice location

3513 Lake Desiard Dr
Monroe, LA 71201-2078

Mailing address

3513 Lake Desiard Dr
Monroe, LA 71201-2078
Phone (318) 366-4379

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20141230001224 LA Practitioner - Physician Assistant 6103149026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
94.47 of 100Reported as group
Improvement activities
40
Cost
73.21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA.200098LAMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1376949636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3513 LAKE DESIARD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012078",
            "telephone_number": "318-366-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3513 LAKE DESIARD DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012078",
            "telephone_number": "318-366-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANNA",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.