Mark S Harriman, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

19879 Issued in TN

Practice address

3045 Kate Bond Rd
Bartlett, TN 38133

Phone

(901) 381-4664

Fax

(901) 373-0809

NPI assigned

Sep 21, 2005

Last updated

Jan 20, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MSK Group PC

  dba OrthoSouth

  • Orthopaedic Surgery Physician
  • Southaven, MS
  • NPI 1912303447
  NPD (past)
• Specialty Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Southaven, MS
  • NPI 1174938344
  NPD (past)

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1851387351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6077 PRIMACY PKWY STE 140",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195742",
            "telephone_number": "901-725-8347",
            "fax_number": "901-259-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 KATE BOND RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38133",
            "telephone_number": "901-381-4664",
            "fax_number": "901-373-0809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4515 Poplar Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381177506",
            "country_code": "US",
            "telephone_number": "901-381-4664",
            "fax_number": "901-373-3804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8040 Wolf River Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381381773",
            "country_code": "US",
            "telephone_number": "901-381-4664",
            "fax_number": "901-373-3804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Exeter Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-641-3000",
            "fax_number": "901-373-0804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIMAN",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "TN",
            "license": "MD0000019879",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "TN",
            "license": "19879",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "00760205",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516452",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86961",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4228373",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OOL",
            "identifier": "0151308",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10505",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139241001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2687125",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "40MD019879",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omar O Hamze, M.D.
• Hardy House Your Family Healthcare Provider, PLLC
• Heather Hardy
• Latonya Simone Hardy, APN
• Rosalynn Denise Hare, MS
• Jennifer Renee Harris, M.S., NCC
• Polly Harris, ED.D., RDN
• Monica Harrison, PHARMD
• Phillip Warren Hart, D.D.S.
• Saniyya Harville

• Sports Medicine (Orthopaedic Surgery) Physician in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.