Active NPI
Elizabeth Ann Harris, PA-C
- Physician Assistant
- Kentwood, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 56010063004
- Practice address
- 4600 Breton Rd SE Ste 102
Kentwood, MI 49508-5220 - Phone
- (616) 391-9700
- NPI assigned
- May 10, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 56010063004 | MI | Primary |
Addresses
Primary practice location
4600 Breton Rd SE Ste 102
Kentwood, MI 49508-5220
Mailing address
100 Michigan St NE
MC 845
Grand Rapids, MI 49503-2560
Other names 1
- Elizabeth Ann Eastman
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | eharris49677@epic00.shdirect.org | ||
| FHIR URL | https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
4600 Breton Rd SE
102 Corewell Health Medical Group West
Grand Rapids, MI 49508-5220
Phone (616) 267-8950
Hospital & facility affiliations
- Spectrum Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56010063004 | MI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Current | Accepting new patients | |
| Spectrum Health Primary Care Partners | Current | Accepting new patients |
Locations
100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
4600 Breton Rd SE
Ste 102
Kentwood, MI 49508
Phone (616) 356-4161
Interoperability endpoints
- eharris49677@epic00.corewelldirect.org
- eharris49677@epic00.shdirect.org
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615939200000",
"number": "1407148307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MICHIGAN ST NE",
"address_2": "MC 845",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4600 BRETON RD SE STE 102",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495085220",
"telephone_number": "616-391-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-10",
"last_updated": "2021-03-17",
"certification_date": "2021-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "56010063004",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "eharris49677@epic00.shdirect.org",
"affiliation": "N",
"address_1": "4600 Breton Rd SE Ste 102",
"city": "Kentwood",
"state": "MI",
"country_code": "US",
"postal_code": "495085220",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "4600 Breton Rd SE Ste 102",
"city": "Kentwood",
"state": "MI",
"country_code": "US",
"postal_code": "495085220",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "EASTMAN",
"middle_name": "ANN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.