NPIMap

Individual provider Active NPI

Carol Harris, MD

  • Interventional Pain Medicine Physician
  • Meridian, MS
National Provider Identifier
1710935671
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
01070601A Issued in IN
Practice address
1314 19TH Ave
Meridian, MS 39301-4116
Phone
(601) 703-4362
Fax
(601) 703-1320
NPI assigned
May 4, 2006
Last updated
Nov 30, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 336060187 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 336060187 IL
Pain Medicine (Anesthesiology) Physician 207LP2900X 01070601A IN
Interventional Pain Medicine Physician 208VP0014X 01070601A IN Primary

Addresses

Primary practice location

1314 19TH Ave
Meridian, MS 39301-4116

Mailing address

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 703-4362

Other identifiers 1

IdentifierTypeStateIssuer
201067100OtherINMEDICAID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070822001341 MS Practitioner - Pain ManagementPractitioner - Anesthesiology 8729050679 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Mississippi School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Practice addresses (Care Compare)

1314 19TH Ave
Meridian, MS 39301-4116
Phone (601) 484-6700

2401 16TH St
Meridian, MS 39301-3950
Phone (601) 482-4181

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
336060187ILMDPain Medicine (Anesthesiology) Physician
01070601AINMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laird Hospital, Inc. CurrentSince Dec 18, 2016 Accepting new patients
Laird Hospital, Inc. CurrentSince Dec 18, 2016 Accepting new patients
Rush Medical Foundation Anesthesiology Current Accepting new patients
Medical Foundation, Inc. Anesthesiology CurrentSince Nov 1, 2015 Accepting new patients
Meridian Anesthesiology Group, Inc Anesthesiology CurrentSince Apr 1, 2017 Accepting new patients
Medical Foundation, Inc. CurrentSince Nov 1, 2015 Accepting new patients
Rush Medical Foundation CurrentSince Jun 13, 2017 Accepting new patients
Laird Hospital, Inc. Current Accepting new patients
Rush Medical Foundation Interventional Pain Medicine CurrentSince Jun 13, 2017 Accepting new patients
Comprehensive Pain Care SC Interventional Pain Medicine Past Accepting new patients
Pain Centers of Chicago LLC Pain Medicine Past Accepting new patients
Southwest Anesthesia Consultants, LLC Past Accepting new patients
Pain Centers of Chicago LLC Pain Medicine Past Accepting new patients
The Pain Medicine & Rehabilitation Center, Inc PastSince Apr 1, 2008 Accepting new patients
American Anesthesiology Associates of Illinois, S.C. Anesthesiology Past Accepting new patients

Locations

9097 Collinsville Rd
Collinsville, MS 39325
Phone (601) 626-8874

1200 16th Ave
Meridian, MS 39301
Phone (601) 703-1901

1314 19th Ave
Meridian, MS 39301
Phone (601) 483-0011

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

1106 Central Dr
Philadelphia, MS 39350
Phone (601) 656-6821

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

25117 Highway 15
Union, MS 39365
Phone (601) 774-1502

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1710935671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-4362",
            "fax_number": "601-703-1320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-703-4362",
            "fax_number": "601-703-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "336060187",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "336060187",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01070601A",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IN",
            "license": "01070601A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "201067100",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.