Kenyetta Harris, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA057725 Issued in PA

Practice address

132 The Meadows Dr
Centre Hall, PA 16828-9231

Phone

(814) 634-2161

NPI assigned

Aug 6, 2015

Last updated

Aug 6, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1730565284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E WATER ST # 812",
            "address_2": "APT:20",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177451530",
            "telephone_number": "267-629-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 THE MEADOWS DR",
            "city": "CENTRE HALL",
            "state": "PA",
            "postal_code": "168289231",
            "telephone_number": "814-634-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KENYETTA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA057725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles J. Falsone, O.D.
• Paige Mary Fuller, DPT
• Matthew Jon Gerhart, RPH
• Olivia Getz, CRNP
• James Edward Grant
• Brenda Renea Hockenberry, LPN
• Mara Lauren Holsinger
• MD Aminul Islam, PA-C
• James Edward Grant
• LHM Physical Therapy Institute LLC

• Medical Physician Assistant in Centre Hall, PA
• Providers in Centre Hall, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.