Individual provider Active NPI

Latoya Jennifer Harris, PA-C

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1912698879
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14479 Issued in NC
Practice address
2010 Baldwin LN
Winston Salem, NC 27103-5846
Phone
(336) 277-1717
Fax
(336) 277-1718
NPI assigned
May 19, 2023
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA3287 KY
Physician Assistant 363A00000X 0010-14479 NC Primary
Medical Physician Assistant 363AM0700X PA3287 KY
Surgical Physician Assistant 363AS0400X PA3287 KY

Addresses

Primary practice location

2010 Baldwin LN
Winston Salem, NC 27103-5846

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 277-1717

Other practice location 1

3101 Beaumont Centre Cir Ste 100
Lexington, KY 40513-1959
Phone (859) 323-5544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230922000572 KY Practitioner - Physician Assistant 6305290578 Reassigns benefits to 1 organization
I20241018001416 NC Practitioner - Physician Assistant 6305290578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsyth Memorial Hospital IncGroup PAC ID 9537071790, 622 clinicians

Practice addresses (Care Compare)

2010 Baldwin LN
Winston Salem, NC 27103-5846
Phone (336) 277-1718

291 Broad St
Kernersville, NC 27284-2932
Phone (336) 993-8181

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013
Phone (336) 718-5000

6301 Stadium Dr
Clemmons, NC 27012-8766
Phone (336) 766-6473

6915 Village Medical Cir
Clemmons, NC 27012-8002
Phone (336) 718-1680

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.76 of 100Reported as group
Quality
78.19
Promoting interoperability
100
Improvement activities
40
Cost
70.17

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3287KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Medical Group, LLC CurrentSince Oct 18, 2024 Accepting new patients
University of Kentucky CurrentSince Sep 8, 2023 Accepting new patients
Novant Health Medical Group, LLC CurrentSince Oct 18, 2024 Accepting new patients
Forsyth Memorial Hospital, Inc. CurrentSince Oct 18, 2024 Accepting new patients

Locations

3101 Beaumont Centre Cir
Ste 100
Lexington, KY 40513
Phone (859) 323-5544

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

6301 Stadium Dr
Clemmons, NC 27012
Phone (336) 766-6473

291 Broad St
Kernersville, NC 27284
Phone (336) 993-8181

5145 Sellers Rd
Shallotte, NC 28470
Phone (910) 754-4441

2010 Baldwin Ln
Winston Salem, NC 27103
Phone (336) 277-1717

2825 Lyndhurst Ave
Ste 101
Winston Salem, NC 27103
Phone (336) 277-6300

Interoperability endpoints

  • Direct secure messaging: lharris1615291@direct.novanthealth.org

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1912698879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-277-1717",
            "fax_number": "336-277-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BALDWIN LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035846",
            "telephone_number": "336-277-1717",
            "fax_number": "336-277-1718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Beaumont Centre Cir Ste 100",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405131959",
            "country_code": "US",
            "telephone_number": "859-323-5544",
            "fax_number": "859-257-9286",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LATOYA",
        "middle_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-19",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3287",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14479",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA3287",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA3287",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.