Individual provider Active NPI

Jessie Harris

  • Clinical Social Worker
  • Cortland, NY
National Provider Identifier
1952729972
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086716 Issued in NY
Practice address
7 Clayton Ave
Cortland, NY 13045-2501
Phone
(607) 758-6100
NPI assigned
Apr 7, 2014
Last updated
Mar 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 078689-1 NY
Clinical Social Worker 1041C0700X 086716 NY Primary

Addresses

Primary practice location

7 Clayton Ave
Cortland, NY 13045-2501

Mailing address

205 Hazel Dr
Vestal, NY 13850-3115
Phone (607) 348-3618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809000631 NY Practitioner - Clinical Social Worker 1254689136 Reassigns benefits to 1 organization
Practice locations: Johnson City, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cortland County County TreasurerGroup PAC ID 3173427028, 17 clinicians

Practice addresses (Care Compare)

111 Port Watson St
Cortland, NY 13045-3185
Phone (607) 428-5461

269 Riverside Dr
Johnson City, NY 13790-2726
Phone (607) 348-3618

7 Clayton Ave
Cortland, NY 13045-2501

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078689-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jacobus Center for Reproductive Health CurrentSince Jun 23, 2018 Accepting new patients
Cortland County County Treasurer Clinical Current Accepting new patients
Cortland County Health Department Nursing Clinics CurrentSince Jun 23, 2018 Accepting new patients

Locations

111 Port Watson St
Cortland, NY 13045
Phone (607) 753-9326

7 Clayton Ave
Cortland, NY 13045
Phone (607) 758-6100

Interoperability endpoints

  • Direct secure messaging: jharris@cortlandcountymentalhealth.medentdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1396828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1952729972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HAZEL DR",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138503115",
            "telephone_number": "607-348-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 CLAYTON AVE",
            "city": "CORTLAND",
            "state": "NY",
            "postal_code": "130452501",
            "telephone_number": "607-758-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JESSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-07",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "078689-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cortland, NY

Sources for this page

Verify at the official NPI Registry.