John E. Harris, M.D.
Individual provider Active NPI Family Medicine Physician · White Hall, AR
NPI 1902888720 · NPPES record last updated Jan 13, 2014
Key facts
- NPI
- 1902888720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- E1963 (AR)
- Practice address
- 7500 Dollarway Rd
Suite 104
White Hall, AR 71602-3027 - Phone
- (870) 247-7632
- Fax
- (870) 247-7641
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 16
Hospital & facility affiliations 10
Owned or controlled facilities with NPI records 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Arkansas College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Access Medical Clinic Arkansas LTC LLC
Access Medical Clinic Arkansas LLC
Arkansas Health Group
Practice addresses (Care Compare)
1010 N Ctr St
Lonoke, AR 72086-2005
Phone (501) 438-8075
1308 E Page Ave
Malvern, AR 72104-4518
Phone (501) 337-9820
217 N Main St
Rison, AR 71665-8856
Phone (870) 219-7706
47 Hwy 64 W
Beebe, AR 72012-9500
Phone (501) 882-3388
7500 Dollarway Rd
Suite 104
White Hall, AR 71602-3082
Phone (870) 247-7632
810 S Rock St
Sheridan, AR 72150-7066
Phone (870) 994-7301
9601 I 630 Exit
Suite 7
Little Rock, AR 72205-7202
Hospital & facility affiliations
- Jefferson Homecare
- Gentiva
- Baptist Health Medical Center-Little Rock
- Jefferson Regional Medical Center
- Baptist Health Medical Center-Drew County
- The Blossoms at Star City Rehab & Nursing Center
- The Green House Cottages of Southern Hills
- Trinity Village Medical Center
- Lonoke Health and Rehab Center, LLC
- Sheridan Healthcare and Rehabilitation Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 23 |
| Skin biopsy | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Trinity Village Medical Center |
Skilled nursing facility | Corporate Officer Adp of the SNF |
Jan 1, 2013 Jan 24, 2025 |
| Lonoke Health and Rehab Center LLC |
Skilled nursing facility | Adp of the SNF | Dec 10, 2024 |
| The Blossoms at Star City Rehab & Nursing Center |
Skilled nursing facility | Adp of the SNF | Aug 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040825000532 | AR | Practitioner - Family Practice | 5597679332 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E1963 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Health Group | Family Medicine | Current |
Accepting new patients |
| Access Medical Clinic Arkansas LLC | Current |
Accepting new patients | |
| Access Medical Clinic Arkansas LTC LLC | Family Medicine | Current |
Accepting new patients |
| Access Medical Clinic Arkansas LTC LLC | Family Medicine | Current |
Accepting new patients |
| Arkansas Health Group | Current |
Accepting new patients | |
| Access Medical Clinic Arkansas LLC | Family Medicine | Current |
Accepting new patients |
| Arkansas Health Group | Family Medicine | Past | Accepting new patients |
| Abdul Ezeldin M.D. P.a. | Past |
Accepting new patients |
Locations
806 E Main St
Flippin, AR 72634
Phone (870) 219-7706
16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706
20 Wilson Farm Rd
Greenbrier, AR 72058
Phone (501) 679-8970
11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215
9500 Kanis Rd
Ste 410
Little Rock, AR 72205
Phone (501) 202-1500
810 S Rock St
Sheridan, AR 72150
Phone (870) 917-2289
106 N Van Buren St
Weiner, AR 72479
Phone (870) 605-0014
7500 Dollarway Rd
Ste 104
White Hall, AR 71602
Phone (870) 247-7632
Interoperability endpoints
- jharris4078@direct.baptist-healthar.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E1963 | AR | Yes |
Addresses
Primary practice location
7500 Dollarway Rd
Suite 104
White Hall, AR 71602-3027
Mailing address
7500 Dollarway Rd
Suite 104
White Hall, AR 71602-3027
Phone (870) 247-7632
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135561001 | Medicaid | AR |
Other providers in White Hall, AR
- Zachary Hale
- Michael Hanna
- Casey Hanson
- Morgan Hardman
- Allen Harris
- Hathaway Family Dentistry, P.a.
- Rafeek Hegazy
- Meketia Henderson
- Tenesha Hill
- Home Medical, Inc
All providers in White Hall, AR · Family Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2014. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- 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.