NPIMap

Individual provider Active NPI

Charles Marvelle Harris

  • Addiction (Substance Use Disorder) Counselor
  • Macon, GA
National Provider Identifier
1700497955
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
890 Northwoods Plaza
Macon, GA 31204
Phone
(478) 330-7164
Fax
(478) 330-7167
NPI assigned
Aug 12, 2020
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

890 Northwoods Plaza
Macon, GA 31204

Mailing address

890 Burrus Rd
Macon, GA 31204-1441
Phone (478) 330-7164

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jhames@healthqwest.us Health Information Exchange (HIE)
Direct Messaging Address jhames@healthwest.us Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthqwest Frontiers LLC CurrentSince Aug 23, 2020 Accepting new patients
Healthqwest Frontiers LLC PastSince Aug 23, 2020 Accepting new patients

Locations

890 Burrus Rd
Macon, GA 31204
Phone (478) 330-7164

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1700497955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 BURRUS RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312041441",
            "telephone_number": "478-330-7164",
            "fax_number": "478-330-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 NORTHWOODS PLAZA",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31204",
            "telephone_number": "478-330-7164",
            "fax_number": "478-330-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHARLES",
        "middle_name": "MARVELLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhames@healthqwest.us",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "890 northwoods plaza",
            "city": "macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31204",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhames@healthwest.us",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "890 northwoods plaza",
            "city": "macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "31204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.