Individual provider Active NPI

John G. Harris Jr., DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
National Provider Identifier
1922068238
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 3181 Issued in FL
Practice address
915 W Monroe St Ste 101
Jacksonville, FL 32204-1177
Phone
(904) 355-1553
Fax
(904) 356-7774
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO 3181 FL Primary

Addresses

Primary practice location

915 W Monroe St Ste 101
Jacksonville, FL 32204-1177

Mailing address

915 W Monroe St Ste 101
Jacksonville, FL 32204-1177
Phone (904) 355-1553

Other identifiers 2

IdentifierTypeStateIssuer
580964184AMedicaidGA
3405826-00MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000012 FL Practitioner - Podiatry 2264437193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Keystone Rehabilitation Systems IncGroup PAC ID 7012826753, shared by 15 NPIs, 750 clinicians

Practice addresses (Care Compare)

2334 S 8TH St
Suite 1
Fernandina Beach, FL 32034-1979
Phone (904) 277-8370

5930 Old French Rd
Erie, PA 16509-3656
Phone (814) 860-7816

Hospital & facility affiliations

  • Concierge Home Care Home health agency, Jacksonville, FL, CCN 687131
  • Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue181
Removal of skin lesions116
Removal of nail tissue606
Removal or shaving of skin growth40
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO 3181FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eighth Street Foot and Ankle LLC Foot & Ankle Surgery CurrentSince Nov 8, 2008 Accepting new patients

Locations

2334 S 8th St
Ste 101
Fernandina Beach, FL 32034

2334 S 8th St
Ste 1
Fernandina Beach, FL 32034
Phone (904) 277-8370

2334 S 8th St
Fernandina Beach, FL 32034
Phone (904) 261-6135

915 W Monroe St
Ste 101
Jacksonville, FL 32204
Phone (904) 355-1553

431 W 8th St
Jacksonville, FL 32206
Phone (904) 355-1553

Organizations & group practices 1

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.

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": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1922068238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-355-1553",
            "fax_number": "904-356-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-355-1553",
            "fax_number": "904-356-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOHN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "580964184A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3405826-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.