Individual provider Active NPI

Dustin Lea Harris, PT

  • Physical Therapist
  • Sacramento, CA
National Provider Identifier
1962775346
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
303645 Issued in CA
Practice address
10398 Rockingham Dr Ste 9
Sacramento, CA 95827-2507
Phone
(916) 693-1837
Fax
(916) 720-0211
NPI assigned
Feb 16, 2012
Reactivated
Jan 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 303645 CA Primary

Addresses

Primary practice location

10398 Rockingham Dr Ste 9
Sacramento, CA 95827-2507

Mailing address

10398 Rockingham Dr Ste 9
Sacramento, CA 95827-2507
Phone (916) 693-1837

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230420002834 CA Practitioner - Physical Therapist in Private Practice 9638534993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grit Performance Physical Therapy IncGroup PAC ID 2466802574, 2 clinicians

Practice addresses (Care Compare)

10398 Rockingham Dr
Suite 9
Sacramento, CA 95827-2507
Phone (916) 693-1837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
303645CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Results Physical Therapy and Training Center Inc. Physical Therapist PastSince Mar 1, 2013 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1962775346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10398 ROCKINGHAM DR STE 9",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272507",
            "telephone_number": "916-693-1837",
            "fax_number": "916-720-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10398 ROCKINGHAM DR STE 9",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272507",
            "telephone_number": "916-693-1837",
            "fax_number": "916-720-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "DUSTIN",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "deactivation_date": "2025-01-02",
        "reactivation_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "303645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.