Active NPI
Paul Alan Harris, O.D.
- Optometrist
- Memphis, TN
National Provider Identifier
1689765786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2951
- Practice address
- 1245 Madison Ave
Memphis, TN 38104-2211 - Phone
- (443) 857-3925
- Fax
- (410) 252-1719
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist | 152WV0400X | TA0816 | MD | |
| Optometrist | 152W00000X | 2951 | TN | Primary |
Addresses
Primary practice location
1245 Madison Ave
Memphis, TN 38104-2211
Mailing address
1245 Madison Ave
Memphis, TN 38104-2211
Phone (901) 722-3250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 399433-02 | Other | MD | BCBS OF MD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA0816 | MD | MD | Vision Therapy Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1689765786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 MADISON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381042211",
"telephone_number": "901-722-3250",
"fax_number": "901-722-3347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1245 MADISON AVE",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381042211",
"telephone_number": "443-857-3925",
"fax_number": "410-252-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "PAUL",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "MD",
"license": "TA0816",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TN",
"license": "2951",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MD",
"identifier": "399433-02",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.