Individual provider Active NPI

Audrey Harris

  • Surgical Physician Assistant
  • Cumming, GA
National Provider Identifier
1528974995
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
14433 Issued in GA
Practice address
4150 Deputy Bill Cantrell Memorial Road
Suite 180
Cumming, GA 30040-9998
Phone
(678) 344-8900
Fax
(678) 666-5201
NPI assigned
Aug 24, 2026
Last updated
Oct 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 14433 GA Primary

Addresses

Primary practice location

4150 Deputy Bill Cantrell Memorial Road
Suite 180
Cumming, GA 30040-9998

Mailing address

1551 Janmar Rd
Snellville, GA 30078-5606
Phone (470) 579-5600

Other practice location 1

11660 Alpharetta Hwy Ste 700
Roswell, GA 30076-4956
Phone (678) 344-8900

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

NPI Registry JSON

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

{
    "created_epoch": "1787529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792108800000",
    "number": "1528974995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785606",
            "telephone_number": "470-579-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DEPUTY BILL CANTRELL MEMORIAL ROAD",
            "address_2": "SUITE 180",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409998",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11660 Alpharetta Hwy Ste 700",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300764956",
            "country_code": "US",
            "telephone_number": "678-344-8900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "AUDREY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-24",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "14433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; 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.