Individual provider Active NPI

Andy Trent Harris, D.C.

  • Chiropractor
  • Smithfield, VA
National Provider Identifier
1770577215
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104000590 Issued in VA
Practice address
607 S Church St
Smithfield, VA 23430-1740
Phone
(757) 357-5400
Fax
(757) 357-0657
NPI assigned
Sep 9, 2005
Reactivated
Mar 31, 2006
Last updated
Dec 7, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104000590 VA Primary

Addresses

Primary practice location

607 S Church St
Smithfield, VA 23430-1740

Mailing address

607 S Church St
Smithfield, VA 23430-1740
Phone (757) 357-5400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100902000058 VA Practitioner - Chiropractic 2961526660 Practice locations: Smithfield, VA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Harris Chiropractic Clinic of Smithfield Chiropractor PastSince Jul 1, 1989 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1770577215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 S CHURCH ST",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234301740",
            "telephone_number": "757-357-5400",
            "fax_number": "757-357-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 S CHURCH ST",
            "city": "SMITHFIELD",
            "state": "VA",
            "postal_code": "234301740",
            "telephone_number": "757-357-5400",
            "fax_number": "757-357-0657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ANDY",
        "middle_name": "TRENT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2007-12-07",
        "deactivation_date": "2006-03-25",
        "reactivation_date": "2006-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104000590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.