Individual provider Active NPI

Joe Tanner Harris, M.D

  • Pediatrics Physician
  • Oxford, MS
National Provider Identifier
1639188303
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10280 Issued in MS
Practice address
2888 S Lamar Blvd
Oxford, MS 38655-5347
Phone
(662) 234-8286
Fax
(662) 234-6644
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10280 MS Primary

Addresses

Primary practice location

2888 S Lamar Blvd
Oxford, MS 38655-5347

Mailing address

2888 S Lamar Blvd
Oxford, MS 38655-5347
Phone (662) 234-8286

Other identifiers 1

IdentifierTypeStateIssuer
00121627MedicaidMS

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 Medicine

State licenses

LicenseStateTypeSpecialty
10280MSMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1639188303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555347",
            "telephone_number": "662-234-8286",
            "fax_number": "662-234-6644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 S LAMAR BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555347",
            "telephone_number": "662-234-8286",
            "fax_number": "662-234-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOE",
        "middle_name": "TANNER",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "10280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00121627",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.