Individual provider Active NPI

Carla Diane Harris, CERTIFIED NURSE PRAC

  • Family Nurse Practitioner
  • Corsicana, TX
National Provider Identifier
1801807136
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
037611322 Issued in TX
Practice address
3201 Corsicana Crossings Blvd Ste 101
Corsicana, TX 75109-9302
Phone
(903) 872-6065
Fax
(903) 872-2975
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R59688 NM
Primary Care Nurse Practitioner 363LP2300X AP112068 TX
Family Nurse Practitioner 363LF0000X 037611322 TX Primary

Addresses

Primary practice location

3201 Corsicana Crossings Blvd Ste 101
Corsicana, TX 75109-9302

Mailing address

3201 Corsicana Crossings Blvd Ste 101
Corsicana, TX 75109-9302
Phone (903) 872-6065

Other identifiers 1

IdentifierTypeStateIssuer
27906728MedicaidNM

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address carla.harris.1@1902.direct.athenahealth.com
Direct Messaging Address carla.harris.1@1902.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050510000489 TX Practitioner - Nurse Practitioner 6204876139 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Employee Assistance Program IncGroup PAC ID 1557260064, 102 clinicians

Practice addresses (Care Compare)

108 N Robb St
Trinity, TX 75862-7602
Phone (409) 594-7632

1602 Rock Prairie Rd
College Station, TX 77845-0001

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Temple, TX, CCN 457096
  • Navarro Regional Hospital Hospital, Corsicana, TX, CCN 450447
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372

Merit-based Incentive Payment System (MIPS)

Final score
88.18 of 100Reported as apm
Quality
71.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R59688NMMDFamily Nurse Practitioner
037611322TXMDFamily Nurse Practitioner
AP112068TXMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Nov 4, 2017 Accepting new patients
Navarro Hospital LP CurrentSince Dec 23, 2023 Accepting new patients
Regional Employee Assistance Program Inc Current Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Nov 4, 2017 Accepting new patients
Navarro Hospital LP CurrentSince Dec 23, 2023 Accepting new patients

Locations

301 Hospital Dr
#150
Corsicana, TX 75110
Phone (903) 641-4800

3201 Corsicana Crossings Blvd
#101
Corsicana, TX 75109

3201 W State Highway 22
Corsicana, TX 75110
Phone (903) 654-6800

3201 Corsicana Crossings Blvd
Ste 101
Corsicana, TX 75109
Phone (903) 872-6065

Interoperability endpoints

  • Direct secure messaging: carla.harris.2@1902.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1801807136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 CORSICANA CROSSINGS BLVD STE 101",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751099302",
            "telephone_number": "903-872-6065",
            "fax_number": "903-872-2975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 CORSICANA CROSSINGS BLVD STE 101",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751099302",
            "telephone_number": "903-872-6065",
            "fax_number": "903-872-2975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CARLA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "CERTIFIED NURSE PRAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R59688",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "AP112068",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "037611322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27906728",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carla.harris.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "3201 Corsicana Crossings Blvd Ste 101",
            "city": "Corsicana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751099302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "carla.harris.1@1902.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3201 Corsicana Crossings Blvd Ste 101",
            "city": "Corsicana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751099302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corsicana, TX

Sources for this page

Verify at the official NPI Registry.