Misty M Harris, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R864994 Issued in MS

Practice address

9421 Eastside Drive Extention
Newton, MS 39345

Phone

(601) 683-0279

Fax

(601) 683-0366

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Newton Hospital, Inc

  • General Acute Care Hospital
  • Newton, MS
  • NPI 1063667939
  NPD (past)
• Newton Hospital, Inc.

  • Emergency Care Clinic/Center
  • Newton, MS
  • NPI 1528061272
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679662928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9421 EASTSIDE DRIVE EXTENTION",
            "city": "NEWTON",
            "state": "MS",
            "postal_code": "39345",
            "telephone_number": "601-683-0279",
            "fax_number": "601-683-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9421 EASTSIDE DRIVE EXTENTION",
            "city": "NEWTON",
            "state": "MS",
            "postal_code": "39345",
            "telephone_number": "601-683-0279",
            "fax_number": "601-683-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MISTY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MS",
            "license": "R864994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "640670312",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fast Pace Mississippi, PLLC
• Footprints Adult Day Services
• Brelan Mikal Gardner, FNP
• Wendy D Gressett, NP-C
• Cheralyn Deanne Harris, M.S., CCC-A
• Victoria Harris
• John Barnes Harrison, D.M.D.
• Nathan Barnes Harrison, DMD
• Holistic Healing to Wellness Counseling
• Hollingsworth Dental Clinic, P.a.

• All providers in Newton, MS
• Pediatric Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.