Gwen Harris

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

RN049410 Issued in GA

Practice address

14901 River St
Blakely, GA 39823-2499

Phone

(229) 723-8099

NPI assigned

Nov 29, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Heritage Inn Retirement Center LLC

  • Assisted Living Facility
  • Blakely, GA
  • NPI 1659495703
  NPD (past) Authorized official
• DPM Brissett Nrga LLC

  • Podiatrist
  • Lithonia, GA
  • NPI 1326040114
  NPD (past)

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

{
    "created_epoch": "1701216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1487420519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14901 RIVER ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232499",
            "telephone_number": "229-723-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 RIVER ST",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398232499",
            "telephone_number": "229-723-8099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GWEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-29",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "GA",
            "license": "RN049410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alesha Lynn Fletcher Sheffield, NP
• Stacey R Gale, PHARMACIST
• Georgia CVS Pharmacy LLC
• Georgia Pines Community Service Board
• Carlye Alderman Giannars, FNP-C
• Shirley R Harris
• Heritage Inn Retirement Center LLC
• E Alex Howell Jr., DMD
• J.H. Harveys Co.
• Josephine Johnson

• All providers in Blakely, GA
• Gerontology Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.