Individual provider Active NPI

Shonna Larell Harris, ANP-C

  • Adult Health Nurse Practitioner
  • Mesquite, TX
National Provider Identifier
1912217167
Registry record updated Nov 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
650775 Issued in TX
Practice address
1575 I 30
Mesquite, TX 75150-6905
Phone
(469) 800-2800
Fax
(469) 800-2801
NPI assigned
Oct 20, 2010
Last updated
Nov 13, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 650775 TX Primary

Addresses

Primary practice location

1575 I 30
Mesquite, TX 75150-6905

Mailing address

PO Box 746079
Atlanta, GA 30374-6079

Other practice location 1

1515 S Buckner Blvd Ste 141
Dallas, TX 75217-1794
Phone (214) 305-7065

Other identifiers 1

IdentifierTypeStateIssuer
650775OtherTXNURSING LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000370 TX Practitioner - Nurse Practitioner 9032380837 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health of Texas PLLCGroup PAC ID 2163843038, 103 clinicians
Dallas County Hospital DistrictGroup PAC ID 8325934813, 597 clinicians

Practice addresses (Care Compare)

1515 S Buckner Blvd
Suite 141
Dallas, TX 75217-1794
Phone (214) 305-7065

5200 Harry Hines Blvd
Dallas, TX 75235-7709
Phone (214) 590-8006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
650775TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 15, 2012 Accepting new patients
Oak Street Health of Texas, PLLC CurrentSince Nov 16, 2020 Accepting new patients
Healthtexas Provider Network CurrentSince Jan 15, 2012 Accepting new patients

Locations

1515 S Buckner Blvd
Ste 141
Dallas, TX 75217
Phone (214) 305-7065

2360 Gus Thomasson Rd
Dallas, TX 75228
Phone (314) 301-7071

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

1950 Ephriham Ave
Fort Worth, TX 76164
Phone (817) 813-7075

4115 E Lancaster Ave
Fort Worth, TX 76103
Phone (817) 796-7370

3500 Little York Rd
#A5
Houston, TX 77093
Phone (281) 707-7358

1575 Interstate 30
Mesquite, TX 75150
Phone (469) 800-2800

2115 S Broadway Ave
Tyler, TX 75701
Phone (903) 907-7002

Interoperability endpoints

  • Direct secure messaging: sharris218864@direct.sw.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1912217167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746079",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 I 30",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506905",
            "telephone_number": "469-800-2800",
            "fax_number": "469-800-2801"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 S Buckner Blvd Ste 141",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752171794",
            "country_code": "US",
            "telephone_number": "214-305-7065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SHONNA",
        "middle_name": "LARELL",
        "name_prefix": "Ms.",
        "credential": "ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "650775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "650775",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

Verify at the official NPI Registry.