NPIMap

Organization Active NPI

Harrison C Carter MD PC

  • Specialist
  • Alma, GA
National Provider Identifier
1619174091
Registry record updated Jan 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
050575 Issued in GA
Legal business name
HARRISON C CARTER MD PC
Practice address
1126 W 12TH St
Alma, GA 31510-1814
Phone
(912) 632-7300
Fax
(912) 632-1326
NPI assigned
Jun 29, 2007
Last updated
Jan 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2019

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

Authorized official

Name
Johnnie Carter
Title
Office Manager
Phone
(912) 632-7300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN106778 GA
Specialist 174400000X 050575 GA Primary

Addresses

Primary practice location

1126 W 12TH St
Alma, GA 31510-1814

Mailing address

1126 W 12TH St
Alma, GA 31510-1814
Phone (912) 632-7300

Other identifiers 2

IdentifierTypeStateIssuer
DA3099OtherGAMEDICARE RAILROAD
000922908AMedicaidGA

Other names 1

  • Harrison Clay Carter Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040419001226 GA Part B Supplier - Clinic/Group Practice 6709871635 Receives reassigned benefits from 4 practitioners
Practice locations: Alma, GA; Baxley, GA
O20220708002263 GA Part B Supplier - Clinic/Group Practice 9335529270 Receives reassigned benefits from 4 practitioners
Practice locations: Alma, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D0992644Harrison C Carter MD1126 West 12TH Street, Alma, GA 31510Certificate of waiverFeb 11, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546819200000",
    "number": "1619174091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 W 12TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315101814",
            "telephone_number": "912-632-7300",
            "fax_number": "912-632-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 W 12TH ST",
            "city": "ALMA",
            "state": "GA",
            "postal_code": "315101814",
            "telephone_number": "912-632-7300",
            "fax_number": "912-632-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISON C CARTER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2019-01-07",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JOHNNIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "912-632-7300"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN106778",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "050575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DA3099",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000922908A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harrison Clay Carter",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Alma, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.