NPIMap

Individual provider Active NPI

Jaclyn Herfarth Harrison, MD

  • Internal Medicine Physician
  • Houston, TX
National Provider Identifier
1760616163
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P4061 Issued in TX
Practice address
1900 North Loop W Ste 580
Houston, TX 77018-8163
Phone
(713) 714-5376
Fax
(713) 325-0759
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X P4061 TX Primary

Addresses

Primary practice location

1900 North Loop W Ste 580
Houston, TX 77018-8163

Mailing address

1900 North Loop W Ste 580
Houston, TX 77018-8163
Phone (713) 714-5376

Other practice location 1

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2000

Other names 1

  • Jaclyn Ailine Herfarth Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121217000059 TX Practitioner - Internal Medicine 1254583438 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at Houston, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

1900 N Loop W
Suite 580
Houston, TX 77018-8163
Phone (713) 714-5376

7900 Fannin St
Suite 4000
Houston, TX 77054-2935
Phone (713) 512-7500

8215 Cypresswood Dr
Spring, TX 77379-7466
Phone (832) 717-0877

Hospital & facility affiliations

  • Accentcare Home Health of Houston - North, LLC Home health agency, Houston, TX, CCN 457741
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184
  • Memorial Hermann Memorial City Hospital Hospital, Houston, TX, CCN 450610

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
P4061TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group Gulf Coast PLLC CurrentSince Jun 25, 2018 Accepting new patients
Hospital Medicine Associates of TX PA Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Privia Medical Group Gulf Coast, PLLC CurrentSince Jun 25, 2018 Accepting new patients
Round Table Physicians Group PLLC Current Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Jun 1, 2016 Accepting new patients
Round Table Specialist Group, PLLC CurrentSince Mar 1, 2020 Accepting new patients

Locations

5701 W Slaughter Ln
Bldg G
Austin, TX 78749
Phone (512) 651-5787

646 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 309-9001

1635 North Loop W
Houston, TX 77008
Phone (713) 867-2066

7900 Fannin St
Ste 4000
Houston, TX 77054
Phone (713) 512-7027

11103 Westheimer Rd
#C
Houston, TX 77042

1900 North Loop W
Ste 580
Houston, TX 77018
Phone (713) 714-5376

1014 Wirt Rd
Ste 200
Houston, TX 77055
Phone (713) 527-5000

800 W Central Texas Expy
Killeen, TX 76541
Phone (254) 220-4117

2900 S Loop 256
Palestine, TX 75801
Phone (903) 731-1021

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

10970 Shadow Creek Pkwy
Ste 100
Pearland, TX 77584
Phone (281) 398-8500

17510 W Grand Pkwy S
Ste 430
Sugar Land, TX 77479
Phone (713) 578-3820

Interoperability endpoints

  • Direct secure messaging: jaclyn.harrison.1@8042.direct.athenahealth.com

Organizations & group practices 7

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.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1760616163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 NORTH LOOP W STE 580",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770188163",
            "telephone_number": "713-714-5376",
            "fax_number": "713-325-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 NORTH LOOP W STE 580",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770188163",
            "telephone_number": "713-714-5376",
            "fax_number": "713-325-0759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1635 North Loop W",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "77008",
            "country_code": "US",
            "telephone_number": "713-867-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JACLYN",
        "middle_name": "HERFARTH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P4061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "HERFARTH",
            "middle_name": "AILINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.