NPIMap

Individual provider Active NPI

Elizabeth Harris, NP

  • Nurse Practitioner
  • Gallup, NM
National Provider Identifier
1962421347
Registry record updated Nov 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3833 Issued in CO
Practice address
516 Nizhoni Blvd
Gallup, NM 87301-5748
Phone
(505) 722-1000
NPI assigned
Jul 18, 2006
Last updated
Nov 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3833 CO Primary

Addresses

Primary practice location

516 Nizhoni Blvd
Gallup, NM 87301-5748

Mailing address

4733 W Moncrieff PL
Denver, CO 80212-1600
Phone (303) 964-8770

Other identifiers 1

IdentifierTypeStateIssuer
2547041MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040426001308 CO Practitioner - Nurse Practitioner 0244227098 Reassigns benefits to 3 organizations
I20230510000803 MT Practitioner - Nurse Practitioner 0244227098 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Broomfield, CO 80021
Phone (720) 807-4461

15389 W 91St Dr
Arvada, CO 80007-1400

8350 Colorado Blvd
Unit 160
Firestone, CO 80504-6803
Phone (303) 673-1370

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3833COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Denver, LLC Current Accepting new patients
Intermountain Front Range, Inc. Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 1, 2014 Accepting new patients
Intermountain Front Range, Inc. CurrentSince Mar 22, 2014 Accepting new patients
Intermountain Front Range, Inc. CurrentSince Mar 22, 2014 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jan 5, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Nov 1, 2014 Accepting new patients
Platte Valley Medical Group LLC CurrentSince Jul 29, 2020 Accepting new patients
Platte Valley Medical Group, LLC CurrentSince Jul 29, 2020 Accepting new patients
North Fork Medical Clinic PC Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 6250
Broomfield, CO 80021
Phone (303) 272-0750

4859 Yampa St
Denver, CO 80249
Phone (303) 498-1885

1450 Dexter St
Ste 101
Fort Lupton, CO 80621
Phone (303) 857-2087

1000 Lincoln St
Fort Morgan, CO 80701
Phone (970) 542-3320

500 Discovery Pkwy
Ste 100
Superior, CO 80027
Phone (303) 403-7800

3210 Lutheran Pkwy
Wheat Ridge, CO 80033
Phone (303) 425-8000

1027 N 27th St
Billings, MT 59101
Phone (406) 237-5110

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257206400000",
    "number": "1962421347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4733 W MONCRIEFF PL",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802121600",
            "telephone_number": "303-964-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 NIZHONI BLVD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015748",
            "telephone_number": "505-722-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "3833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2547041",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

Verify at the official NPI Registry.