Jeremy Reed Harrison

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

H620436762480 Issued in FL

Practice address

3409 Green Oaks LN
Middleburg, FL 32068-3421

Phone

(757) 392-4087

NPI assigned

May 2, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619913600000",
    "number": "1497338016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 GREEN OAKS LN",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683421",
            "telephone_number": "757-392-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 GREEN OAKS LN",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320683421",
            "telephone_number": "757-392-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JEREMY",
        "middle_name": "REED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-02",
        "certification_date": "2021-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "H620436762480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H620436762480",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "bieeileen12@gmail.com",
            "affiliation": "N",
            "endpointDescription": "nurse",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3409 Green Oaks Ln",
            "city": "Middleburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320683421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diann B. Hall, RN
• Mary Grace Hall, RN
• Amanda Lei Hammock, MASSAGE THERAPIST
• Michael Hanna, M.D
• Harris Wilcox and Donovan PA
• Kevia Hart
• Natasha Danielle Hatcher, APRN
• Michael L Hay, O.D.
• Health Advantages, P.a.
• Clanailya Henry, LMHC

• Dermatology Physician in Middleburg, FL
• Providers in Middleburg, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.