Katrina Ermayne Harris

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

Practice address

667 Addison Dr
Wynne, AR 72396-1602

Phone

(870) 208-7113

NPI assigned

Oct 25, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katrina Harris Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Charlie'S Angels Transit, LLC

  • Non-emergency Medical Transport (VAN)
  • Wynne, AR
  • NPI 1043976343
  NPD Authorized official
• Charlie'S Angels Transit, LLC

  • PACE Provider Organization
  • Wynne, AR
  • NPI 1740946292
  NPD Authorized official

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1881358992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 ADDISON DR",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723961602",
            "telephone_number": "870-208-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 ADDISON DR",
            "city": "WYNNE",
            "state": "AR",
            "postal_code": "723961602",
            "telephone_number": "870-208-7113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KATRINA",
        "middle_name": "ERMAYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "HARRIS",
            "credential": "CEO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristin Hallmark
• Heather Hamm
• Harmony Health Clinic Wynne, PLLC
• Harmony Health Clinic Wynne, PLLC
• Cambra Harris, QBHP
• Leron Harris, OT-A
• William Harris
• Health Resources of Ar
• Thomas Reynolds Heisler, PH.D.
• Tyler Linn Hendrix, OTA

• All providers in Wynne, AR
• Adult Development & Aging Psychologist in Arkansas

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