Donnis Kline Harrison, MD
Individual provider Active NPI Orthopaedic Surgery Physician · Pascagoula, MS
NPI 1619902814 · NPPES record last updated Mar 22, 2017
Key facts
- NPI
- 1619902814
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 19197 (MS)
- Practice address
- 3615 Hospital St
Pascagoula, MS 39581-4112 - Phone
- (228) 762-3664
- Fax
- (228) 769-7015
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Orthopedic Surgery
- Education
- University of Mississippi School of Medicine, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bienville Orthopaedic Specialists, LLC
Practice addresses (Care Compare)
6300 E Lake Blvd
Suite 201
Vancleave, MS 39565-6771
Phone (228) 230-2663
Hospital & facility affiliations
- Deaconess Homecare- Region I
- Singing River Health System
- Singing River Gulfport
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Knee replacement | 1-10 |
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 62 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061016000113 | MS | Practitioner - Orthopedic Surgery | 2062418056 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19197 | MS | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bienville Orthopaedic Specialists, LLC | Orthopaedic Surgery | Current |
Accepting new patients |
| Oal Care of Al, LLC | Orthopaedic Surgery | Current |
Accepting new patients |
| Bienville Orthopaedic Specialists, LLC | Orthopaedic Surgery | Current |
Accepting new patients |
Locations
1720A Medical Park Dr
Ste 220
Biloxi, MS 39532
Phone (228) 392-9355
838 Mill St
Ste D
Lucedale, MS 39452
Phone (251) 633-0573
3615 Hospital St
Pascagoula, MS 39581
Phone (228) 762-3664
6300 E Lake Blvd
Ste 301
Vancleave, MS 39565
6300 E Lake Blvd
Ste 201
Vancleave, MS 39565
Phone (228) 206-2263
102 Woodmont Blvd
Ste 350
Nashville, TN 37205
Phone (615) 297-1020
Interoperability endpoints
- donnis.harrison@bienvilleortho.emadirect.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 19197 | MS | Yes |
Addresses
Primary practice location
3615 Hospital St
Pascagoula, MS 39581-4112
Mailing address
6300 E Lake Blvd
Suite 301
Vancleave, MS 39565-6770
Phone (228) 230-2663
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00983228 | Medicaid | MS |
Other providers in Pascagoula, MS
- Marshall Hammond
- Amanda Hanson
- Huntington T Hapworth
- Melissa Harkey
- Telena T Harmon
- John David Harry
- Kylie Hart
- Hannah Camille Harwell
- James Lee Harwell
- Iesha Cherelle Haynes
All providers in Pascagoula, MS · Orthopaedic Surgery Physician in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.