W Richard Harris MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301027079 Issued in MI

Legal business name

W RICHARD HARRIS MD LLC

Practice address

4295 Farr Rd
Fruitport, MI 49415-9753

Phone

(231) 865-6428

NPI assigned

Nov 9, 2007

Last updated

Oct 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William Richard Harris, MD

Title

Owner

Phone

(231) 865-6428

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• W RICHARD HARRIS Other name

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224720000000",
    "number": "1770763443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1148",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431148",
            "telephone_number": "231-727-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 FARR RD",
            "city": "FRUITPORT",
            "state": "MI",
            "postal_code": "494159753",
            "telephone_number": "231-865-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W RICHARD HARRIS MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2008-10-23",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-865-6428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301027079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104233136",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0806136201",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "W RICHARD HARRIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chad Uptigrove, DO
• Kristina Demitra Valkanas, M.D.
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• Hannah Vegh, LLMSW
• Kostadinos Vergos, DO
• Kristen M Wagner, D.O.
• Christine Ann Wiswell, R.T.R.
• Kristen Kay Woods, MD
• X-Cell Integrative Health PC
• David W Ziemke

• Family Medicine Physician in Fruitport, MI
• Providers in Fruitport, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2008; 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.