Jennifer Harris

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

906936 Issued in MS

Practice address

2149 Stateline Rd W
Southaven, MS 38671-1222

Phone

(662) 342-1112

Fax

(662) 393-1478

NPI assigned

Sep 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midsouth MedicineGroup PAC ID 3971579400, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GCEIBA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midsouth Medicine

  • Internal Medicine Physician
  • Southaven, MS
  • NPI 1194894147
  Medicare reassignment Care Compare group NPD
• Stonebridge Medical Group, PLC

  • Adult Health Nurse Practitioner
  • Jackson, TN
  • NPI 1487977369
  NPD (past)

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

{
    "created_epoch": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1912733148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 STATELINE RD W DEPT 1102",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711222",
            "telephone_number": "662-342-1112",
            "fax_number": "662-393-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711222",
            "telephone_number": "662-342-1112",
            "fax_number": "662-393-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin M Harley, LCSW
• Ava Kristen Harmon, OTR/L
• Harmony Health, PLLC
• Erin Elizabeth Harrington, DNP, FNP-BC
• Jamieka Harris, LMSW
• Kameshia Harris, RN
• Kashayla Harris, FNP
• Latoya Yvette Harris, PTA
• Nicholas Martin Harris, PTA
• Nieka Harris, M.D.

• Family Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.