Carson R Harris, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

31091 Issued in MN

Practice address

8040 Old Cedar Ave S Ste 100
Bloomington, MN 55425-1205

Phone

(651) 254-3456

Fax

(651) 254-5216

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Alliance Wellness Clinic Inc.

  • Methadone Clinic
  • Bloomington, MN
  • NPI 1780186130
  NPD
• Regions Hospital

  dba HealthPartners Specialty Center Woodbury

  • General Acute Care Hospital
  • Woodbury, MN
  • NPI 1104681105
  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1598730152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "MC21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-7172",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 OLD CEDAR AVE S STE 100",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251205",
            "telephone_number": "651-254-3456",
            "fax_number": "651-254-5216"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1730 Clifton Pl",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554033242",
            "country_code": "US",
            "telephone_number": "612-813-1581 x6649",
            "fax_number": "612-871-2154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CARSON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "31091",
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "MN",
            "license": "31091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53585100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Haring-Becher
• Marena Harley
• Gregory Allan Harms, D.D.S.
• Katherine Alice Harrell
• Marc William Harrie, O.D.
• Kathryn Harris
• Amanda J Harrison, PAC
• Hala Mohamed Harte
• Keeva Nicole Hartley, MSW LICSW
• Kristin Hartley, LICSW

• Addiction Medicine (Preventive Medicine) Physician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Addiction Medicine (Preventive Medicine) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.