Active NPI
Reed J Harris, D.O.
- Cardiovascular Disease Physician
- Twin Falls, ID
National Provider Identifier
1780616888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- O-96
- Practice address
- 775 Pole Line Rd W
Suite 112
Twin Falls, ID 83301-5814 - Phone
- (208) 814-8200
- Fax
- (208) 933-4921
- NPI assigned
- Jul 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | O-96 | ID | Primary |
Addresses
Primary practice location
775 Pole Line Rd W
Suite 112
Twin Falls, ID 83301-5814
Mailing address
PO Box 587
Twin Falls, ID 83303-0587
Phone (208) 814-7400
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 804255200 | Medicaid | ID | |
| P00380063 | Other | ID | RR MEDICARE |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| O-96 | ID | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Magic Valley Regional Medical Center | Past | Accepting new patients | |
| St Luke'S Magic Valley Regional Medical Center LTD | Past | Accepting new patients | |
| St Luke'S Clinic LLC | Cardiovascular Disease | Past | Accepting new patients |
Organizations & group practices 3
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.
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- Psychiatric Hospital
- Twin Falls, ID
- NPI 1447208947
-
- Community/Retail Pharmacy
- Twin Falls, ID
- NPI 1760203921
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1780616888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 587",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833030587",
"telephone_number": "208-814-7400",
"fax_number": "208-814-7491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "775 POLE LINE RD W",
"address_2": "SUITE 112",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015814",
"telephone_number": "208-814-8200",
"fax_number": "208-933-4921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "REED",
"middle_name": "J",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "ID",
"license": "O-96",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "804255200",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00380063",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.