Individual provider Active NPI

Chivas Michelle Harris, FNP-C

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1639647357
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN221502 Issued in GA
Practice address
325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923
Phone
(617) 505-1520
NPI assigned
Nov 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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 RN221502 GA Primary

Addresses

Primary practice location

325 N Saint Paul St Ste 3100
Dallas, TX 75201-3923

Mailing address

1 Castle Hill Rd
Savannah, GA 31419-6602
Phone (912) 800-3733

Other practice location 1

1 Castle Hill Rd
Savannah, GA 31419-6602
Phone (912) 800-3733

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191112003661 GA Practitioner - Nurse Practitioner 3779915756 Reassigns benefits to 1 organization
I20230223002518 TX Practitioner - Nurse Practitioner 3779915756 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN221502GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Mar 20, 2021 Accepting new patients
Post Acute Specialists of Texas PA Nurse Practitioner CurrentSince Jan 1, 2023 Accepting new patients
Privia Medical Group of Georgia LLC CurrentSince Mar 20, 2021 Accepting new patients
Steward Center for Palliative Care CurrentSince Sep 1, 2019 Accepting new patients
Northwest Iowa Hospital Corporation Nurse Practitioner Past Accepting new patients
Saint Francis Medical Center Nurse Practitioner Past Accepting new patients
Northwest Iowa Hospital Corporation Past Accepting new patients
Form Health Associates Ma, P.C. Past Accepting new patients

Locations

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

4700 Waters Ave
Fl 1
Savannah, GA 31404
Phone (912) 350-3438

4700 Waters Ave
#1
Savannah, GA 31404

4700 Waters Ave
Savannah, GA 31404
Phone (912) 273-1100

2911 Medical Arts St
Ste 10
Austin, TX 78705
Phone (512) 474-5551

307 W Cypress St
San Antonio, TX 78212
Phone (210) 223-5521

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1639647357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CASTLE HILL RD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314196602",
            "telephone_number": "912-800-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N SAINT PAUL ST STE 3100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752013923",
            "telephone_number": "617-505-1520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Castle Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314196602",
            "country_code": "US",
            "telephone_number": "912-800-3733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHIVAS",
        "middle_name": "MICHELLE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN221502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.