Individual provider Active NPI

Wesley J. Harris, M.D., FACOG

  • Specialist
  • Abingdon, VA
National Provider Identifier
1720037773
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15150 Issued in TN
Practice address
16000 Johnston Memorial Dr Ste 200
Abingdon, VA 24211-7664
Phone
(276) 628-4335
NPI assigned
May 8, 2006
Last updated
Dec 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15150 TN Primary

Addresses

Primary practice location

16000 Johnston Memorial Dr Ste 200
Abingdon, VA 24211-7664

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

249 Midway Medical Park
Bristol, TN 37620-1693
Phone (423) 968-3033

Other practice location 2

208 Medical Park Blvd
Bristol, TN 37620-7343
Phone (423) 989-4050

Other practice location 3

102 15th St NW Ste 301
Norton, VA 24273-1627
Phone (276) 439-1470

Other identifiers 1

IdentifierTypeStateIssuer
006215475MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wharris15598@balladhealth.medalliesdirect.net Direct BLUE RIDGE MEDICAL MANAGEMENT CORPORATION

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221130003641 VA Practitioner - Obstetrics/Gynecology 8022043686

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15150TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Medical Management Corporation Current Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

Interoperability endpoints

  • Direct secure messaging: wesleyharris@bgynobpc.allscriptsdirect.net

Organizations & group practices 1

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1720037773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 JOHNSTON MEMORIAL DR STE 200",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242117664",
            "telephone_number": "276-628-4335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "249 Midway Medical Park",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376201693",
            "country_code": "US",
            "telephone_number": "423-968-3033",
            "fax_number": "423-968-3789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "208 Medical Park Blvd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376207343",
            "country_code": "US",
            "telephone_number": "423-989-4050",
            "fax_number": "423-990-3044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 15th St NW Ste 301",
            "address_purpose": "LOCATION",
            "city": "Norton",
            "state": "VA",
            "postal_code": "242731627",
            "country_code": "US",
            "telephone_number": "276-439-1470",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WESLEY",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D., FACOG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "15150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006215475",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wharris15598@balladhealth.medalliesdirect.net",
            "affiliation": "Y",
            "endpointDescription": "Ballad Health Care Everywhere",
            "affiliationName": "BLUE RIDGE MEDICAL MANAGEMENT CORPORATION",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "249 Midway Medical Park",
            "city": "Bristol",
            "state": "TN",
            "country_code": "US",
            "postal_code": "376201693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.