Individual provider Active NPI

Miriam Harris

  • Community Health Worker
  • Clayton, MO
National Provider Identifier
1477912624
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
LC001473531 Issued in MO
Practice address
141 N Meramec Ave Ste 10a
Clayton, MO 63105-4093
Phone
(314) 517-3337
Fax
(314) 553-9358
NPI assigned
Feb 16, 2016
Last updated
Aug 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X LC001473531 MO Primary

Addresses

Primary practice location

141 N Meramec Ave Ste 10a
Clayton, MO 63105-4093

Mailing address

141 N Meramec Ave Ste 10a
Clayton, MO 63105-4093
Phone (314) 517-3337

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC001473531MOMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acts in Home, LLC Current Accepting new patients
Acts Wound Care Company LLC Current Accepting new patients
Acts of Care, LLC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1477912624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 N MERAMEC AVE STE 10A",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631054093",
            "telephone_number": "314-517-3337",
            "fax_number": "314-553-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 N MERAMEC AVE STE 10A",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631054093",
            "telephone_number": "314-517-3337",
            "fax_number": "314-553-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MIRIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MO",
            "license": "LC001473531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; 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.