Individual provider Active NPI

Cheryl Harris, M.D.

  • Pediatrics Physician
  • Columbus, IN
National Provider Identifier
1841225075
Registry record updated Sep 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
10341111 Issued in IN
Practice address
2150 25TH St Ste B
Columbus, IN 47201-3243
Phone
(812) 376-9219
Fax
(812) 378-4821
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 10341111 IN Primary

Addresses

Primary practice location

2150 25TH St Ste B
Columbus, IN 47201-3243

Mailing address

PO Box 775383
Chicago, IL 60677-5383
Phone (812) 376-5315

Other identifiers 2

IdentifierTypeStateIssuer
100358600MedicaidIN
000000984525OtherINANTHEM PIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address charris7648@edirect.crh.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320000715 IN Practitioner - Pediatric Medicine 9234567546 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
10341111INMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Regional Health Physicians, LLC CurrentSince Feb 2, 2020 Accepting new patients
Columbus Regional Health Physicians, LLC Pediatrics CurrentSince Feb 2, 2020 Accepting new patients
Major Hospital Past Accepting new patients
Columbus Regional Health Physicians, LLC Past Accepting new patients

Locations

2400 17th St
Columbus, IN 47201
Phone (812) 373-3025

1120 N Marr Rd
Columbus, IN 47201
Phone (317) 948-8896

2150 25th St
Ste B
Columbus, IN 47201
Phone (812) 376-9219

Organizations & group practices 4

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1841225075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 775383",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606775383",
            "telephone_number": "812-376-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 25TH ST STE B",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013243",
            "telephone_number": "812-376-9219",
            "fax_number": "812-378-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "CHERYL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "10341111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100358600",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000984525",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "charris7648@edirect.crh.org",
            "affiliation": "N",
            "endpointDescription": "Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Address",
            "address_1": "1120 N Marr Rd",
            "city": "Columbus",
            "state": "IN",
            "country_code": "US",
            "postal_code": "472015505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

Verify at the official NPI Registry.