Roger Stanley Harris, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101007120 Issued in MI

Practice address

39880 Van Dyke Ave Ste 202
Sterling Heights, MI 48313-4670

Phone

(586) 264-7930

Fax

(586) 264-7931

NPI assigned

Jul 18, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rharris143902@direct.hfhs.org

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.

• Visiting Wound Specialists & Primary Care PLLC

  • Family Medicine Physician
  • Sterling Heights, MI
  • NPI 1760268940
  NPD

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1730188269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39880 VAN DYKE AVE STE 202",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134670",
            "telephone_number": "586-264-7930",
            "fax_number": "586-264-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39880 VAN DYKE AVE STE 202",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483134670",
            "telephone_number": "586-264-7930",
            "fax_number": "586-264-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ROGER",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-18",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101007120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371362",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1371353",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Harris
• Kayla Harris
• Kiyla Harris
• Lawanda Sharice Harris I
• Lindsey Harris
• Shatyra Harris
• Tristan Harris
• Alexis Harrison
• Antonella Hart
• Kevin S. Hartig, BC/HIS

• Family Medicine Physician in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.