Jeffrey L Harris, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M-9259 Issued in ID

Practice address

325 Warner Dr
Lewiston, ID 83501-4437

Phone

(208) 798-8500

Fax

(208) 798-8530

NPI assigned

Jul 7, 2006

Last updated

Nov 5, 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 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Providence Health & Services - Washington

  dba Poplar Medical Complex DME

  • Durable Medical Equipment & Medical Supplies
  • Walla Walla, WA
  • NPI 1174814552
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1942232285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014437",
            "telephone_number": "208-798-8500",
            "fax_number": "208-798-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 WARNER DR",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014437",
            "telephone_number": "208-798-8500",
            "fax_number": "208-798-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JEFFREY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00034232",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-9259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806974300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8289035",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Harlow
• Randall Wayne Harper, PH.D., M.ED., B.S.ED
• Larry Dean Harries, MD
• Cindy Renea Harris-Lindauer, LMSW
• Cody Bryan Harris, CNP
• Juan David Hart
• Cassidy F Hartshorn, LICSW,LCSW
• Grace Lynn Hartwig
• Krista Lynn Harwick, NP-C
• Shelby Hasenoehrl, LPC

• Internal Medicine Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Internal Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.