Active NPI
Ida Misty Nicole Harris, PHARM D
- Pharmacist
- Bluefield, WV
National Provider Identifier
1609154913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0007393
- Practice address
- 4248 Coal Heritage Rd
Bluefield, WV 24701-9190 - Phone
- (304) 589-6868
- NPI assigned
- Aug 3, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0007393 | WV | Primary |
Addresses
Primary practice location
4248 Coal Heritage Rd
Bluefield, WV 24701-9190
Mailing address
PO Box 29
Bluefield, VA 24605-0029
Phone (304) 922-1735
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0007393 | WV | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1609154913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29",
"city": "BLUEFIELD",
"state": "VA",
"postal_code": "246050029",
"telephone_number": "304-922-1735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4248 COAL HERITAGE RD",
"city": "BLUEFIELD",
"state": "WV",
"postal_code": "247019190",
"telephone_number": "304-589-6868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "IDA",
"middle_name": "MISTY NICOLE",
"credential": "PHARM D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-03",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WV",
"license": "0007393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bluefield, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.