NPIMap

Individual provider Active NPI

Toni Harris, MD

  • Pain Medicine Physician
  • Fayetteville, NC
National Provider Identifier
1922173889
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
35361 Issued in NC
Practice address
2035 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688
Phone
(910) 323-8454
Fax
(910) 321-0656
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X 35361 NC Primary

Addresses

Primary practice location

2035 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3688

Mailing address

PO Box 3426
Wilmington, NC 28406-0426
Phone (910) 395-5590

Other identifiers 2

IdentifierTypeStateIssuer
8939989MedicaidNC
39989OtherNCBLUE CROSS OF NC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050203000221 NC Practitioner - AnesthesiologyPractitioner - Pain Management 9032168216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Tufts University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2035 Valleygate Dr
Suite 201
Fayetteville, NC 28304-3749
Phone (910) 323-8454

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Carolina Pain Management Center Inc Pain Medicine CurrentSince May 1, 1994 Accepting new patients

Locations

2035 Valleygate Dr
Ste 201
Fayetteville, NC 28304
Phone (910) 323-8454

1520 Harbour Dr
Wilmington, NC 28401
Phone (910) 395-5590

1902 Tradd Ct
Wilmington, NC 28401
Phone (910) 251-8474

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1922173889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3426",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284060426",
            "telephone_number": "910-395-5590",
            "fax_number": "910-395-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035 VALLEYGATE DR",
            "address_2": "SUITE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043688",
            "telephone_number": "910-323-8454",
            "fax_number": "910-321-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TONI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NC",
            "license": "35361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8939989",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NC",
            "identifier": "39989",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.