Keith R. Harris, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

050930 Issued in GA

Practice address

100 Market Place Blvd Ste 300
Cartersville, GA 30121-8717

Phone

(470) 490-9600

Fax

(470) 447-1815

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Tulane University School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas Dermatology and Skin Cancer Specialists LLCGroup PAC ID 1658680764, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health Floyd Medical Center Hospital, Rome, GA, CCN 110054
• Piedmont Cartersville Medical Center Hospital, Cartersville, GA, CCN 110030

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: kharris@sedermatology.emadirect.md

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.

• Douglas Dermatology and Skin Cancer Specialists LLC

  • Dermatology Physician
  • Douglasville, GA
  • NPI 1275929267
  Medicare reassignment Care Compare group
• Gwinnett Dermatology PC D/B/a Georgia Dermatology Partners

  • Dermatology Physician
  • Snellville, GA
  • NPI 1477596203
  NPD (past)
• Wesley S Wilborn MD PC

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1750554978
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cartersville Medical Center LLC

  • General Acute Care Hospital
  • Cartersville, GA
  • NPI 1780638833
  Care Compare affiliation
• Floyd Healthcare Management Inc

  • General Acute Care Hospital
  • Rome, GA
  • NPI 1154377166
  Care Compare affiliation

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1922090224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 JOHN MADDOX DR NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651419",
            "telephone_number": "706-235-7711",
            "fax_number": "706-235-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARKET PLACE BLVD STE 300",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301218717",
            "telephone_number": "470-490-9600",
            "fax_number": "470-447-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KEITH",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "050930",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "050930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynne Harrell, RN, IBCLC
• Tracey-Ann Harriott, FNP-BC
• Harris Counseling & Consulting Services, Inc.
• Angela Dawn Harris, LPC
• Dionne Harris
• Kiwanna Lanta Harshaw
• Milana Harvey
• April Hatcher, RPH
• Monique Headrick, DC
• Healing Hand Clinic Inc

• Dermatology Physician in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; 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.