Organization Active NPI

Gordon a Harris PH D & Associates Inc

  • Psychologist
  • Dayton, OH
National Provider Identifier
1730347980
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
GORDON A HARRIS PH D & ASSOCIATES INC
Practice address
5400 N Main St
Dayton, OH 45415-3453
Phone
(937) 274-2226
Fax
(937) 274-2074
NPI assigned
May 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Jennifer Thompson
Title
Office Manager
Phone
(937) 274-2226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

5400 N Main St
Dayton, OH 45415-3453

Mailing address

5400 N Main St
Dayton, OH 45415-3453
Phone (937) 274-2226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081212000006 OH Part B Supplier - Clinic/Group Practice 9739113895 Receives reassigned benefits from 1 practitioner
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

5400 N Main St
Dayton, OH 45415
Phone (937) 274-2226

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1730347980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153453",
            "telephone_number": "937-274-2226",
            "fax_number": "937-274-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454153453",
            "telephone_number": "937-274-2226",
            "fax_number": "937-274-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON A HARRIS PH D & ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "937-274-2226"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.