Individual provider Active NPI

Emily Harrison, MD

  • Family Medicine Physician
  • Wellington, FL
National Provider Identifier
1457647190
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME128626 Issued in FL
Practice address
10111 Forest Hill Blvd RM 255
Wellington, FL 33414-6141
Phone
(561) 377-7131
Fax
(866) 219-0330
NPI assigned
Jun 21, 2011
Last updated
May 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME128626 FL Primary

Addresses

Primary practice location

10111 Forest Hill Blvd RM 255
Wellington, FL 33414-6141

Mailing address

10111 Forest Hill Blvd RM 255
Wellington, FL 33414-6141
Phone (561) 377-7131

Other identifiers 1

IdentifierTypeStateIssuer
6128AOtherFLMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181129000707 FL Practitioner - Family Practice 7719159680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitalmd Group Holding LLCGroup PAC ID 8921091786, 535 clinicians

Practice addresses (Care Compare)

1447 Medical Park Blvd
Wellington, FL 33414-3183

3225 Aviation Ave
Suite 700
Miami, FL 33133-4741
Phone (305) 273-4641

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME128626FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalmd Group Holding LLC Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Wellington Regional Medical Center LLC Past Accepting new patients

Locations

3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641

Interoperability endpoints

  • Direct secure messaging: drharrison@haysmd1008.srs-direct.com
  • Direct secure messaging: emily.harrison.1@18547.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1457647190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 FOREST HILL BLVD RM 255",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146141",
            "telephone_number": "561-377-7131",
            "fax_number": "866-219-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 FOREST HILL BLVD RM 255",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334146141",
            "telephone_number": "561-377-7131",
            "fax_number": "866-219-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "EMILY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME128626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "6128A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.