Active NPI
Michael Thomas Harris, MD
- Family Medicine Physician
- Idaho Falls, ID
National Provider Identifier
1952579021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- M6846
- Practice address
- 3422 S 15TH E
Idaho Falls, ID 83404-8262 - Phone
- (208) 552-1222
- Fax
- (208) 552-3377
- NPI assigned
- Feb 12, 2008
- Last updated
- Feb 12, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M6846 | ID | Primary |
Addresses
Primary practice location
3422 S 15TH E
Idaho Falls, ID 83404-8262
Mailing address
3422 S 15TH E
Idaho Falls, ID 83404-8262
Phone (208) 552-1222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DG0410 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M6846 | ID | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BMH Inc | Current | Accepting new patients |
Locations
98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763
Interoperability endpoints
- michaelharris@bmh.medalliesdirect.net
Organizations & group practices 2
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.
-
- Primary Care Clinic/Center
- Idaho Falls, ID
- NPI 1285621532
-
- Critical Access Hospital
- Blackfoot, ID
- NPI 1982805271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202774400000",
"number": "1952579021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3422 S 15TH E",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834048262",
"telephone_number": "208-552-1222",
"fax_number": "208-552-3377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3422 S 15TH E",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834048262",
"telephone_number": "208-552-1222",
"fax_number": "208-552-3377"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "MICHAEL",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-12",
"last_updated": "2008-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ID",
"license": "M6846",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DG0410",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.