Individual provider Active NPI

Nkechi Stellamaris Harris

  • Home Health Registered Nurse
  • Woodbury, MN
National Provider Identifier
1821838103
Registry record updated May 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
2498182 Issued in MN
Practice address
6812 Buckingham CT
Woodbury, MN 55125-2401
Phone
(763) 318-3635
NPI assigned
May 25, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WH0200X 2498182 MN Primary

Addresses

Primary practice location

6812 Buckingham CT
Woodbury, MN 55125-2401

Mailing address

PO Box 25914
Woodbury, MN 55125-0914
Phone (763) 318-3635

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

LicenseStateTypeSpecialty
2498182MNMDHome Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1716595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716595200000",
    "number": "1821838103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25914",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551250914",
            "telephone_number": "763-318-3635",
            "fax_number": "651-461-9264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6812 BUCKINGHAM CT",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252401",
            "telephone_number": "763-318-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "NKECHI",
        "middle_name": "STELLAMARIS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-25",
        "last_updated": "2024-05-25",
        "certification_date": "2024-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "2498182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2024; 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.