Glenn Ray Harris, MD
Individual provider Active NPI Family Medicine Physician · Laurinburg, NC
NPI 1538245394 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1538245394
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 9300142 (NC)
- Practice address
- 700A Progress PL
Laurinburg, NC 28352-5545 - Phone
- (910) 276-6767
- NPI assigned
- Oct 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Owned or controlled facilities with NPI records 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 6
| Facility | Type | Role | Since |
|---|---|---|---|
| Scotland Memorial Hospital |
Hospital | Corporate Director | Mar 24, 2005 |
| Pembroke Family Practice & Urgent Care |
Rural health clinic | Corporate Director | Jan 1, 2017 |
| Maxton Family Practice Center |
Rural health clinic | Corporate Director | Jan 1, 2017 |
| Scotland Urgent Care Center |
Rural health clinic | Corporate Director | Mar 29, 2005 |
| Laurinburg Family Practice and Urgent Care |
Rural health clinic | Corporate Director | Oct 1, 2018 |
| Wagram Family Practice |
Rural health clinic | Corporate Director | Jan 1, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050927001289 | NC | Practitioner - Family Practice | 9931155686 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Scotland Regional Health Network | Current |
Accepting new patients | |
| Scotland Regional Health Network | Family Medicine | Current |
Accepting new patients |
| Scotland Regional Health Network | Current | Accepting new patients | |
| Hospice of Scotland County, Inc | Family Medicine | Current |
Accepting new patients |
| Harris Family Practice PLLC | Family Medicine | Current |
Accepting new patients |
| Carolina Family Clinic PA | Family Medicine | Past |
Accepting new patients |
| Hospice of Scotland County, Inc | Family Medicine | Past | Accepting new patients |
Locations
100 N 6th St
Ste 900A
Minneapolis, MN 55403
610 Lauchwood Dr
Laurinburg, NC 28352
Phone (910) 276-7176
500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227
101 Plaza Rd
Laurinburg, NC 28352
Phone (910) 276-1058
700A Progress Pl
Laurinburg, NC 28352
Phone (910) 276-1702
24420 Marlboro St
Wagram, NC 28396
Phone (910) 369-3136
Interoperability endpoints
- gharris306828@carolinashealthcaresystem.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 9300142 | NC | Yes |
Addresses
Primary practice location
700A Progress PL
Laurinburg, NC 28352-5545
Mailing address
PO Box 19305
Charlotte, NC 28219-9305
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gharris306828@CarolinasHealthcareSystem.direct-ci.com | Atrium Health | |
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | ABILITY Network |
Other providers in Laurinburg, NC
- Tina Shook Hammonds
- Candace Austin Harms
- Robert Kenneth Harrell
- Harris Family Practice PLLC
- Christine Nicole Harris
- Jonathon Lawrence Harris
- Melanie Harris
- Kristen Harte
- Harvey Kohn, MD, PLLC
- William G Hatchell
All providers in Laurinburg, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.