Individual provider Active NPI

Marie L Harris, ARNP

  • Women's Health Nurse Practitioner
  • Richland, WA
National Provider Identifier
1568475119
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP30003633 Issued in WA
Practice address
945 Goethals Dr Ste 200
Richland, WA 99352-3552
Phone
(509) 942-2555
Fax
(509) 942-0321
NPI assigned
Aug 14, 2006
Last updated
Dec 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP30003633 WA Primary

Addresses

Primary practice location

945 Goethals Dr Ste 200
Richland, WA 99352-3552

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

5908 Bedford St
Pasco, WA 99301-6605
Phone (509) 547-4724

Other identifiers 2

IdentifierTypeStateIssuer
9624875MedicaidWA
0247415OtherWALABOR & INDUSTRIES

Other names 1

  • Marie L Bacon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090423000749 WA Practitioner - Nurse Practitioner 0749338127 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

945 Goethals Dr
Suite 200
Richland, WA 99352-3552
Phone (509) 942-2555

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Dec 21, 2023 Accepting new patients
Physicians Immediate Care & Medical Centers, P.S. CurrentSince Oct 30, 2020 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Associated Physicians for Women Past Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients

Locations

3900 S Zintel Way
Kennewick, WA 99337
Phone (509) 942-3125

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

1516 Jadwin Ave
Richland, WA 99354
Phone (509) 946-1695

310 Torbett St
Richland, WA 99354
Phone (509) 946-1695

550 Gage Blvd
Ste 101
Richland, WA 99352

780 Swift Blvd
Ste 130
Richland, WA 99352
Phone (509) 942-3244

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

900 Stevens Dr
Richland, WA 99352
Phone (509) 942-3180

945 Goethals Dr
Ste 200
Richland, WA 99352
Phone (509) 942-2555

Interoperability endpoints

  • Direct secure messaging: mharris1108369@wm.providencedirect.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1568475119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 GOETHALS DR STE 200",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523552",
            "telephone_number": "509-942-2555",
            "fax_number": "509-942-0321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5908 Bedford St",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "993016605",
            "country_code": "US",
            "telephone_number": "509-547-4724",
            "fax_number": "509-547-4881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARIE",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "WA",
            "license": "AP30003633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9624875",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0247415",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "BACON",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.