Amanda J Harris, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704361205 Issued in MI

Practice address

1096 S Belsay Rd Ste a
Burton, MI 48509-1948

Phone

(810) 742-6100

NPI assigned

Aug 13, 2018

Last updated

Jan 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
• Mount Carmel Dublin Hospital, Dublin, OH, CCN 360375
• Mount Carmel St Ann's Hospital, Westerville, OH, CCN 360012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aharris4072342@direct.trinity-health.org

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.

• Mount Carmel Healthproviders Inc

  dba Mount Carmel Medical Group

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1356384143
  Medicare reassignment Care Compare group NPD
• Mount Carmel Health Providers Inc

  dba Northland Family Practice

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1831364876
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mount Carmel Health System

  • General Acute Care Hospital
  • Westerville, OH
  • NPI 1417037045
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Grove City, OH
  • NPI 1710067376
  Care Compare affiliation
• Mount Carmel Health System

  dba Mount Carmel Dublin

  • General Acute Care Hospital
  • Dublin, OH
  • NPI 1710752183
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1982784534
  Care Compare affiliation

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1457830275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7433 STONEVALLEY BLF",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483484375",
            "telephone_number": "304-617-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1096 S BELSAY RD STE A",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091948",
            "telephone_number": "810-742-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN.426870",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704361205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leema Hamoudah, DO
• Melody Marie Hanson
• Happy Dental PLLC (Creekwood Dental)
• Angelene Hardy
• Deanne M Harmon
• Andrew Harris
• Deashia Roshell Harris
• Jasmin Laquay Harris
• Lonie Clinton Harris, D.C.
• Tracy L Harris

• Nurse Practitioner in Burton, MI
• Providers in Burton, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.

Verify at the official NPI Registry.