Individual provider Active NPI

Mary E. Harris, CFNP

  • Family Nurse Practitioner
  • Bay St Louis, MS
National Provider Identifier
1861522807
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R569488 Issued in MS
Practice address
149 Drinkwater Rd
Bay St Louis, MS 39520-1658
Phone
(228) 467-8676
Fax
(228) 467-8674
NPI assigned
Mar 7, 2007
Last updated
Jan 23, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R569488 MS Primary

Addresses

Primary practice location

149 Drinkwater Rd
Bay St Louis, MS 39520-1658

Mailing address

149 Drinkwater Rd
Bay St Louis, MS 39520-1658
Phone (228) 467-8676

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R569488MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Keith Van Meter & Associates Past Accepting new patients
Ochsner Medical Center - Hancock LLC Past Accepting new patients
Ochsner Medical Center - Hancock, LLC Past Accepting new patients
Hancock Medical Health Services, Inc. PastSince Jan 1, 2011 Accepting new patients
David F. Roberts, MD Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1861522807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201658",
            "telephone_number": "228-467-8676",
            "fax_number": "228-467-8674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 DRINKWATER RD",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395201658",
            "telephone_number": "228-467-8676",
            "fax_number": "228-467-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARY",
        "middle_name": "E.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R569488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay St Louis, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.