Individual provider Active NPI

Jonathan Lee Harris, CRNA

  • Certified Registered Nurse Anesthetist
  • Dover, NH
National Provider Identifier
1821090754
Registry record updated Apr 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
0447722311 Issued in NH
Practice address
789 Central Ave
Dover, NH 03820-2526
Phone
(603) 742-5252
NPI assigned
Aug 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 0447722311 NH Primary

Addresses

Primary practice location

789 Central Ave
Dover, NH 03820-2526

Mailing address

3998 Fair Ridge Dr
Suite 300
Fairfax, VA 22033-2907
Phone (703) 295-9360

Other identifiers 1

IdentifierTypeStateIssuer
30342007MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040623000334 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860477825 Reassigns benefits to 4 organizations
I20140401001350 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2860477825 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
0447722311NHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia New Hampshire LLP CurrentSince Nov 1, 2013 Accepting new patients
Apollo Medical Group of Wentworth PLLC Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2020 Accepting new patients
Stratham Anesthesia Associates PLLC CurrentSince Aug 14, 2013 Accepting new patients
Portsmouth Anesthesia Associates PA CurrentSince Feb 20, 2002 Accepting new patients
Gbaa Holdings, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Anesthesia Care Group PC Past Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Past Accepting new patients

Locations

45 Discovery Way
#A
Acton, MA 01720
Phone (617) 936-7683

175 Worcester St
Wellesley Hls, MA 02481
Phone (617) 272-0004

120 W Center St
West Bridgewater, MA 02379
Phone (508) 230-8181

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

11 Whitehall Rd
Rochester, NH 03867
Phone (603) 330-7905

6 Works Way
Somersworth, NH 03878
Phone (603) 285-9273

4 West Rd
Ste B1
Stratham, NH 03885
Phone (603) 772-2076

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429833600000",
    "number": "1821090754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 FAIR RIDGE DR",
            "address_2": "SUITE 300",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332907",
            "telephone_number": "703-295-9360",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "789 CENTRAL AVE",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202526",
            "telephone_number": "603-742-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JONATHAN",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2015-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "0447722311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30342007",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.