Active NPI
Jared Harris, MD
- Family Medicine Physician
- Moultrie, GA
National Provider Identifier
1841828894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11685
- Practice address
- 1 Magnolia CT
Moultrie, GA 31768-6764 - Phone
- (229) 502-9769
- NPI assigned
- Mar 27, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 1 | ||
| Family Medicine Physician | 207Q00000X | 11685 | GA | Primary |
Addresses
Primary practice location
1 Magnolia CT
Moultrie, GA 31768-6764
Mailing address
1 Magnolia CT
Moultrie, GA 31768-6764
Phone (229) 502-9769
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11685 | GA | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1841828894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MAGNOLIA CT",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686764",
"telephone_number": "229-502-9769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MAGNOLIA CT",
"city": "MOULTRIE",
"state": "GA",
"postal_code": "317686764",
"telephone_number": "229-502-9769"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "JARED",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-27",
"last_updated": "2022-02-17",
"certification_date": "2022-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": "1",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "11685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moultrie, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.