Individual provider Active NPI

Marquita Shanta Harris, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Greenville, NC
National Provider Identifier
1720713522
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5016504 Issued in NC
Practice address
704 Cromwell Dr Ste a
Greenville, NC 27858-5894
Phone
(252) 486-6573
Fax
(855) 595-2926
NPI assigned
Jul 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5016504 NC Primary

Addresses

Primary practice location

704 Cromwell Dr Ste a
Greenville, NC 27858-5894

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954

Other practice location 1

502 Red Banks Rd Ste A
Greenville, NC 27858-5751
Phone (855) 501-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221017001216 NC Practitioner - Nurse Practitioner 2769858778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mindpath Care Centers North Carolina PLLCGroup PAC ID 4688655517, 115 clinicians

Practice addresses (Care Compare)

502 Red Banks Rd
Suite a
Greenville, NC 27858-5751
Phone (252) 758-4810

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Mental Health & Wellness, PLLC Psychiatric/Mental Health CurrentSince Nov 8, 2025 Accepting new patients
Mindpath Care Centers, North Carolina, PLLC Psychiatric/Mental Health CurrentSince Mar 1, 2026 Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

502 Red Banks Rd
Ste A
Greenville, NC 27858
Phone (252) 758-4810

2120 E Fire Tower Rd
Ste 1071140
Greenville, NC 27858

704 Cromwell Dr
Ste A
Greenville, NC 27858
Phone (252) 220-0420

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1720713522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 CROMWELL DR STE A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585894",
            "telephone_number": "252-486-6573",
            "fax_number": "855-595-2926"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "502 Red Banks Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278585751",
            "country_code": "US",
            "telephone_number": "855-501-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARQUITA",
        "middle_name": "SHANTA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-18",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5016504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.