Active NPI
Candace M Harris, LMT
- Specialist
- Tucker, GA
National Provider Identifier
1780031229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MT007107
- Practice address
- 2015 Montreal Rd
Tucker, GA 30084-5224 - Phone
- (678) 751-2526
- NPI assigned
- May 14, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MT007107 | GA | Primary |
Addresses
Primary practice location
2015 Montreal Rd
Tucker, GA 30084-5224
Mailing address
2015 Montreal Rd
Tucker, GA 30084-5224
Phone (678) 751-2526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT007107 | GA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463184000000",
"number": "1780031229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 MONTREAL RD",
"city": "TUCKER",
"state": "GA",
"postal_code": "300845224",
"telephone_number": "678-751-2526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 MONTREAL RD",
"city": "TUCKER",
"state": "GA",
"postal_code": "300845224",
"telephone_number": "678-751-2526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "CANDACE",
"middle_name": "M",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-14",
"last_updated": "2016-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "GA",
"license": "MT007107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucker, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.