Active NPI
Douglas B. Harris, M.D.
- Family Medicine Physician
- Thibodaux, LA
National Provider Identifier
1679566830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 012278
- Practice address
- 804 South Acadia Road
Thibodaux, LA 70301-4850 - Phone
- (985) 446-2680
- Fax
- (985) 447-2528
- NPI assigned
- Aug 23, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 012278 | LA | Primary |
Addresses
Primary practice location
804 South Acadia Road
Thibodaux, LA 70301-4850
Mailing address
804 South Acadia Road
Thibodaux, LA 70301-4850
Phone (985) 446-2680
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1155349 | Medicaid | LA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012278 | LA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1679566830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SOUTH ACADIA ROAD",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014850",
"telephone_number": "985-446-2680",
"fax_number": "985-447-2528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 SOUTH ACADIA ROAD",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703014850",
"telephone_number": "985-446-2680",
"fax_number": "985-447-2528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "DOUGLAS",
"middle_name": "B.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-23",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "LA",
"license": "012278",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1155349",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.