Samuel Isaac Harris, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024174324 Issued in VA

Practice address

1944 Laskin Rd Ste 402
Virginia Beach, VA 23454-4280

Phone

(757) 524-2356

Fax

(855) 266-7454

NPI assigned

Nov 19, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Aug 15, 2022 through Aug 15, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

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.

• Coastal Counseling Center Inc

  • Mental Health Counselor
  • Chesapeake, VA
  • NPI 1639264112
  NPD (past)
• Ronald W. Atwood, M.D., P.C.

  • Family Medicine Physician
  • Chesapeake, VA
  • NPI 1982637575
  NPD (past)

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1457695173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2252 HATTON ST",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511704",
            "telephone_number": "423-943-7983",
            "fax_number": "855-266-7454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 LASKIN RD STE 402",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234544280",
            "telephone_number": "757-524-2356",
            "fax_number": "855-266-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SAMUEL",
        "middle_name": "ISAAC",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-19",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024174324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leanna Harper Harris, NP
• Miranda Harris, WHNP
• Pamela Harris
• Robert E Harris
• Ronjeanna Harris
• Stephanie Ann Harris
• Tensis Coretta Harris, MA
• Tiychereigna Harris, CSFA
• Tonya Monique Harris
• Ty'Shaun Erik Harris

• Psychiatric/Mental Health Nurse Practitioner in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.