John Ewing Harris, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071005273 Issued in IL

Practice address

2921 Greenbriar Dr Ste B1
Springfield, IL 62704-6440

Phone

(217) 546-3118

Fax

(217) 546-3184

NPI assigned

Oct 11, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Texas Tech University Health Science Center School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psychological Services of Central Illinois PCGroup PAC ID 5193722452, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Psychological Services of Central Illinois, P.C.

  • Clinical Psychologist
  • Springfield, IL
  • NPI 1245281583
  Medicare reassignment Care Compare group NPD
• Killian and Associates SC

  • Psychiatry Physician
  • Springfield, IL
  • NPI 1487642708
  NPD (past)

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613260800000",
    "number": "1558359828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 GREENBRIAR DR STE B1",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046440",
            "telephone_number": "217-546-3118",
            "fax_number": "217-546-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 GREENBRIAR DR STE B1",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046440",
            "telephone_number": "217-546-3118",
            "fax_number": "217-546-3184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOHN",
        "middle_name": "EWING",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2021-02-14",
        "certification_date": "2021-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071005273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfred N Harney, M.D.
• Carol M. Harper, P.A.-C.
• Laurel Harper
• Asia Harris
• Dawn Fairley Harris, PHD
• Justin Alexander Harris
• Lawrence Edward Harris, MA, BSW, CADC
• Madelyn Harris
• Rebecca L. Harris, NP
• Alex Harrison, DO

• Psychologist in Springfield, IL
• Providers in Springfield, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.