Fantasia Midori Harris, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

705421 Issued in TX

Practice address

1380 River Bend Dr
Dallas, TX 75247-4914

Phone

(214) 743-6159

Fax

(214) 689-6482

NPI assigned

Jun 24, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Fantasia Midori Ellis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Duncanville Mental Health Services

  • Community/Behavioral Health Agency
  • Dallas, TX
  • NPI 1710474077
  NPD (past)
• Hope Starts Here LLC

  • Psychiatry Physician
  • Arlington, TX
  • NPI 1053185983
  NPD (past)
• Medhealth

  • Urgent Care Clinic/Center
  • Grand Prairie, TX
  • NPI 1558762690
  NPD (past)

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387843200000",
    "number": "1467891341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474914",
            "telephone_number": "214-743-6159",
            "fax_number": "214-689-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 RIVER BEND DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474914",
            "telephone_number": "214-743-6159",
            "fax_number": "214-689-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "FANTASIA",
        "middle_name": "MIDORI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "705421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FANTASIA",
            "last_name": "ELLIS",
            "middle_name": "MIDORI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Deborah Harris, SLP
• Dustin Harris, M.D.
• Elisabeth Harris, MS,RD,CSP,LD,CNSC
• Elizabeth Ann Harris
• Erica E Harris, LCSW
• Helen Joyce Harris, CRNA
• Hilary Ann Harris, M.A., LPC-ASSOCIATE
• Irene Harris, CRNA
• J Scott Harris, DC
• James Harris, PSY D.

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.