Individual provider Active NPI

William Michael Harris, DO

  • Internal Medicine Physician
  • Chesapeake, WV
National Provider Identifier
1891772802
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1320 Issued in WV
Practice address
11950 Maccorkle Ave
Chesapeake, WV 25315-1135
Phone
(304) 220-2111
Fax
(304) 220-2183
NPI assigned
Dec 30, 2005
Last updated
Jun 18, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1320 WV
Internal Medicine Physician 207R00000X 1320 WV Primary

Addresses

Primary practice location

11950 Maccorkle Ave
Chesapeake, WV 25315-1135

Mailing address

66 Dutch Ridge Rd
Clendenin, WV 25045-9528
Phone (304) 968-3033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20040503000179 WV Practitioner - Internal MedicinePractitioner - Emergency Medicine 5799773511 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Healthcare CenterGroup PAC ID 5496090037, 2 clinicians

Practice addresses (Care Compare)

11950 Maccorkle Ave
Chesapeake, WV 25315-1135
Phone (304) 220-2111

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Healthcare Center CurrentSince Nov 28, 2018 Accepting new patients
Jonathan B Murphy MD Inc Past Accepting new patients
New Century Emergency Physician of West Virginia Inc Emergency Medicine Past Accepting new patients
National Emergency Services West Virginia Inc Emergency Medicine Past Accepting new patients
Appalachian Regional Healthcare, Inc Past Accepting new patients
Appalachian Regional Healthcare, Inc. Past Accepting new patients

Locations

11950 Maccorkle Ave
Marmet, WV 25315
Phone (304) 220-2111

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1891772802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 DUTCH RIDGE RD",
            "city": "CLENDENIN",
            "state": "WV",
            "postal_code": "250459528",
            "telephone_number": "304-968-3033",
            "fax_number": "304-968-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11950 MACCORKLE AVE",
            "city": "CHESAPEAKE",
            "state": "WV",
            "postal_code": "253151135",
            "telephone_number": "304-220-2111",
            "fax_number": "304-220-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "1320",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "1320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, WV

Sources for this page

Verify at the official NPI Registry.