Individual provider Active NPI

Phyllis Jean Harter, FNP

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1619086816
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
063773 Issued in MO
Practice address
440 E Tampa St
Springfield, MO 65806-1131
Phone
(417) 831-0150
Fax
(417) 831-0155
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 063773 MO Primary

Addresses

Primary practice location

440 E Tampa St
Springfield, MO 65806-1131

Mailing address

PO Box 5681
Springfield, MO 65801-5681
Phone (417) 831-0150

Other identifiers 1

IdentifierTypeStateIssuer
424657633MedicaidMO

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
063773MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas Medical Group, LLC Past Accepting new patients
Ozark Family Clinic, Inc PastSince Sep 1, 2007 Accepting new patients
Advocates for a Healthy Community, Inc Past Accepting new patients
Sharlin Health and Neurology, LLC PastSince Oct 26, 2015 Accepting new patients
Randall E Halley DO Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1619086816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5681",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658015681",
            "telephone_number": "417-831-0150",
            "fax_number": "417-831-0155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 E TAMPA ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061131",
            "telephone_number": "417-831-0150",
            "fax_number": "417-831-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTER",
        "first_name": "PHYLLIS",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "063773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424657633",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.

Verify at the official NPI Registry.