NPIMap

Individual provider Active NPI

John E. Harris, M.D.

  • Family Medicine Physician
  • White Hall, AR
National Provider Identifier
1902888720
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E1963 Issued in 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
Last updated
Jan 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E1963 AR Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000532 AR Practitioner - Family Practice 5597679332 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions23
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E1963ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic Arkansas LLC CurrentSince Aug 28, 2019 Accepting new patients
Arkansas Health Group Family Medicine CurrentSince Nov 2, 2013 Accepting new patients
Access Medical Clinic Arkansas LLC Family Medicine CurrentSince Aug 28, 2019 Accepting new patients
Access Medical Clinic Arkansas LTC LLC Family Medicine CurrentSince Nov 15, 2023 Accepting new patients
Access Medical Clinic Arkansas LTC LLC Family Medicine CurrentSince Nov 15, 2023 Accepting new patients
Arkansas Health Group CurrentSince Nov 2, 2013 Accepting new patients
Abdul Ezeldin M.D. P.a. PastSince Jan 1, 2012 Accepting new patients
Arkansas Health Group Family Medicine 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

  • Direct secure messaging: jharris4078@direct.baptist-healthar.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Trinity Village Medical CenterPine Bluff, AR, CCN 045438 Skilled nursing facility Corporate Officer
Adp of the SNF		 Jan 1, 2013
Jan 24, 2025
Lonoke Health and Rehab Center LLCLonoke, AR, CCN 045289 Skilled nursing facility Adp of the SNF Dec 10, 2024
The Blossoms at Star City Rehab & Nursing CenterStar City, AR, CCN 045269 Skilled nursing facility Adp of the SNF Aug 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 10

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389571200000",
    "number": "1902888720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 DOLLARWAY RD",
            "address_2": "SUITE 104",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716023027",
            "telephone_number": "870-247-7632",
            "fax_number": "870-247-7641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 DOLLARWAY RD",
            "address_2": "SUITE 104",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716023027",
            "telephone_number": "870-247-7632",
            "fax_number": "870-247-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOHN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E1963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Hall, AR

Sources for this page

Verify at the official NPI Registry.