Sebastian M Harris, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01074347A Issued in IN

Practice address

750 Broadway
Suite 350
Fort Wayne, IN 46802-1411

Phone

(260) 423-2682

Fax

(260) 422-4326

NPI assigned

Jun 13, 2013

Last updated

Oct 10, 2014By the provider in NPPES

Sex

Male

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 IA

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

Emergency Medicine

Education

University of Oklahoma College of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jefferson County HospitalGroup PAC ID 9335059575, shared by 4 NPIs, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sunny Brook Home Care Home health agency, Fairfield, IA, CCN 167290
• Jefferson County Health Center Hospital, Fairfield, IA, CCN 161364

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Jefferson County Hospital

  dba Jefferson County Health Center

  • Critical Access Hospital
  • Fairfield, IA
  • NPI 1376648329
  Medicare reassignment NPD
• Jefferson County Hospital

  dba JCHC Richland Clinic

  • Rural Health Clinic/Center
  • Richland, IA
  • NPI 1881294536
  Medicare reassignment NPD
• Jefferson County Hospital

  dba JCHC Provider Services

  • Family Medicine Physician
  • Fairfield, IA
  • NPI 1245643972
  NPD
• Fort Wayne Medical Education Program

  dba The Family Medicine Center

  • Family Medicine Physician
  • Fort Wayne, IN
  • NPI 1184635153
  NPD (past)
• Jefferson County Hospital

  dba JCHC Rural Health Clinic

  • Rural Health Clinic/Center
  • Fairfield, IA
  • NPI 1457728008
  NPD (past)

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

• Jefferson County Hospital

  dba Jefferson County Health Center

  • Critical Access Hospital
  • Fairfield, IA
  • NPI 1376648329
  Care Compare affiliation
• Sunnybrook Homecare LLC

  dba Sunnybrook Home Care

  • Home Health Agency
  • Fairfield, IA
  • NPI 1396407417
  Care Compare affiliation

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1932547718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 150",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 BROADWAY",
            "address_2": "SUITE 350",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468021411",
            "telephone_number": "260-423-2682",
            "fax_number": "260-422-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "SEBASTIAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01074347A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Elaine Harris
• Julianne Lisa Harris, RPH
• Laketia Arnet Harris
• Mindy Harris, FNP
• Miranda Harris
• Harrison Dental Group I LLC
• Harrison Dental Group II, LLC (Harrison Dental Group)
• Harrison Dental Group III LLC
• Harrison Dental Group IV LLC
• Chelsea L Harrison

• Family Medicine Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2014; 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.