Individual provider Active NPI

Wade Allen Harris, M.D.

  • Psychiatry Physician
  • Greenville, SC
National Provider Identifier
1972552040
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
10417 Issued in SC
Practice address
701 Grove Rd
Suite 200
Greenville, SC 29605-4271
Phone
(864) 455-8431
Fax
(864) 455-8981
NPI assigned
May 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 10417 SC Primary

Addresses

Primary practice location

701 Grove Rd
Suite 200
Greenville, SC 29605-4271

Mailing address

One Independence Pointe
Suite 212
Greenville, SC 29615-4566
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
104176MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031121000604 SC Practitioner - Psychiatry 7911801881 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Prisma Health University Medical Group CurrentSince Jan 1, 2010 Accepting new patients
Greenville Health System Past Accepting new patients
Piedmont Psychiatric Service PA Psychiatry PastSince Jul 1, 1998 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306

877 W Faris Rd
Ste C
Greenville, SC 29605
Phone (864) 455-8147

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600

10 Patewood Dr
Ste 130
Greenville, SC 29615
Phone (864) 455-8988

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

701 Grove Rd
Ste 200
Greenville, SC 29605
Phone (864) 455-8431

Organizations & group practices 4

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": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360540800000",
    "number": "1972552040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE INDEPENDENCE POINTE",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154566",
            "telephone_number": "864-797-6044",
            "fax_number": "864-797-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 GROVE RD",
            "address_2": "SUITE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054271",
            "telephone_number": "864-455-8431",
            "fax_number": "864-455-8981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WADE",
        "middle_name": "ALLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "10417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104176",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.