Jacqueline K Harris, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A093734 Issued in IA

Practice address

101 W Washington St
Montezuma, IA 50171-7739

Phone

(641) 623-5690

NPI assigned

Nov 23, 2005

Last updated

Nov 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jharris826366@direct.unitypoint.org

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.

• Grinnell Regional Medical Center

  dba Unitypoint Health - Grinnell Professional Services

  • Family Medicine Physician
  • Grinnell, IA
  • NPI 1437663242
  Medicare reassignment NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Grinnell Regional Medical Center

  dba Lynnville Medical Clinic

  • Family Medicine Physician
  • Lynnville, IA
  • NPI 1548336084
  NPD (past)
• Grinnell Regional Medical Center

  dba Victor Health Center

  • Rural Health Clinic/Center
  • Victor, IA
  • NPI 1720154263
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1962485813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "MONTEZUMA",
            "state": "IA",
            "postal_code": "501710430",
            "telephone_number": "641-623-5690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W WASHINGTON ST",
            "city": "MONTEZUMA",
            "state": "IA",
            "postal_code": "501717739",
            "telephone_number": "641-623-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-23",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A093734",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "A093734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Life Health Care, Inc.
• Diamond Trail Dental PC (Diamond Trail Dental)
• Sara Erselius, LISW, RPT
• Grinnell Regional Medical Center (Unitypoint Health - Grinnell Montezuma Medical Clinic)
• GRX Holdings LLC
• Heartland Pediatric Feeding Disorders Services
• Melinda Sue McNaul, ARNP
• Monte Pharmacies LLC (Medicap Pharmacy)
• Montezuma Community School District
• Montezuma Smiles

• Family Nurse Practitioner in Montezuma, IA
• Providers in Montezuma, IA by specialty
• Family Nurse Practitioner in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.