Active NPI
Marc Evan Harr, MD
- Orthopaedic Surgery Physician
- Daytona Beach, FL
National Provider Identifier
1417971201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 0028036
- Practice address
- 1630 Mason Ave
Daytona Beach, FL 32117-4547 - Phone
- (386) 274-5252
- Fax
- (386) 274-5544
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 0028036 | FL | Primary |
Addresses
Primary practice location
1630 Mason Ave
Daytona Beach, FL 32117-4547
Mailing address
2500 S Peninsula Dr
Daytona Beach, FL 32118-5510
Phone (386) 274-5252
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0028036 | Other | FL | MEDICAL LISCENSE |
| 036759100 | Medicaid | FL | |
| 592731139 | Other | FL | TAX IDENTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0028036 | FL | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279497600000",
"number": "1417971201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 S PENINSULA DR",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321185510",
"telephone_number": "386-274-5252",
"fax_number": "386-274-5544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 MASON AVE",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321174547",
"telephone_number": "386-274-5252",
"fax_number": "386-274-5544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARR",
"first_name": "MARC",
"middle_name": "EVAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2010-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "0028036",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LISCENSE",
"identifier": "0028036",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036759100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION",
"identifier": "592731139",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.