William Michael Harris, DO
Individual provider Active NPI Internal Medicine Physician · Chesapeake, WV
NPI 1891772802 · NPPES record last updated Jun 18, 2019
Key facts
- NPI
- 1891772802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 1320 (WV)
- Practice address
- 11950 Maccorkle Ave
Chesapeake, WV 25315-1135 - Phone
- (304) 220-2111
- Fax
- (304) 220-2183
- NPI assigned
- Dec 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Chesapeake Healthcare Center
Practice addresses (Care Compare)
11950 Maccorkle Ave
Chesapeake, WV 25315-1135
Phone (304) 220-2111
Hospital & facility affiliations
- Mountaineer Homecare
- Thomas Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040503000179 | WV | Practitioner - Internal Medicine |
5799773511 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1320 | WV | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chesapeake Healthcare Center | Current |
Accepting new patients | |
| National Emergency Services West Virginia Inc | Emergency Medicine | Past | Accepting new patients |
| Appalachian Regional Healthcare, Inc | Past | Accepting new patients | |
| Jonathan B Murphy MD Inc | Past | Accepting new patients | |
| Appalachian Regional Healthcare, Inc. | Past | Accepting new patients | |
| New Century Emergency Physician of West Virginia Inc | Emergency Medicine | Past | Accepting new patients |
Locations
11950 Maccorkle Ave
Marmet, WV 25315
Phone (304) 220-2111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 1320 | WV | |
| Internal Medicine Physician | 207R00000X | 1320 | WV | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001316637 | Other | WV | WV BCBS |
| P00030193 | Other | WV | CH1 RAILROAD MEDICARE |
| 1056879 | Other | WV | WV DWC |
| 5530031 | Other | WV | AETNA |
| P00059183 | Other | WV | CH2 RAILROAD MEDICARE |
| 0077610000 | Medicaid | WV |
Other providers in Chesapeake, WV
- Wyonna June Alderman
- Chesapeake Healthcare Center
- Chesapeake Healthcare Center
- Christina L Garris
- Leah Renae Gregg
- Melissa Jean Hill
- Connie Kirk
- Synthia Nicole Miller
- Penny Lea Ramsey
- Joshua L Shrewsbery
All providers in Chesapeake, WV · Internal Medicine Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.