Individual provider Active NPI

Yulanda Belle Harrison, MD

  • Family Medicine Physician
  • Osceola, AR
National Provider Identifier
1487973673
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-7875 Issued in AR
Practice address
616 W. Keiser
Osceola, AR 72370-3504
Phone
(870) 563-5888
Fax
(870) 563-6175
NPI assigned
May 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X AR
Family Medicine Physician 207Q00000X E-7875 AR Primary

Addresses

Primary practice location

616 W. Keiser
Osceola, AR 72370-3504

Mailing address

PO Box 1960
Jonesboro, AR 72401-1960
Phone (870) 563-5888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170925000836 GA Practitioner - Family Practice 0648414599 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-7875ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Family Medicine CurrentSince Sep 11, 2017 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. Past Accepting new patients
J. Moore M.D. LLC Past Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

750 Townpark Ln NW
Kennesaw, GA 30144
Phone (770) 514-5401

200 Crescent Center Pkwy
Tucker, GA 30084
Phone (770) 496-3609

Interoperability endpoints

  • Direct secure messaging: yulanda.harrsion.1@11076.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1274918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1487973673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1960",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724011960",
            "telephone_number": "870-563-5888",
            "fax_number": "870-563-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 W. KEISER",
            "city": "OSCEOLA",
            "state": "AR",
            "postal_code": "723703504",
            "telephone_number": "870-563-5888",
            "fax_number": "870-563-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "YULANDA",
        "middle_name": "BELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-27",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-7875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Osceola, AR

Sources for this page

Verify at the official NPI Registry.