Andy Trent Harris, D.C.

Key facts

NPI

1770577215

Entity type

Individual (NPI type 1)

Primary specialty

Chiropractor 111N00000X

License

0104000590 (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

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Harris Chiropractic Clinic of Smithfield Chiropractor · Smithfield, VA · NPI 1003987850
  NPD (past) Authorized official CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment

Enrolled in VA

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 7, 2007.

{
    "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "057742",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "541502583",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAILHANDLERS",
            "identifier": "541502583",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN SPECILITY HEALTH",
            "identifier": "100353600",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Smithfield, VA · Chiropractor in Virginia