Mark William Harris, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CH0005746 Issued in FL

Practice address

956 International Pkwy Ste 1580
Lake Mary, FL 32746-5219

Phone

(407) 706-1420

Fax

(407) 705-3062

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Harris Chiropractic Clinic Inc

  • Chiropractor
  • Lake Mary, FL
  • NPI 1609061985
  Medicare reassignment NPD Authorized official
• Centre for Alternative Medicine, Inc

  • Chiropractor
  • Casselberry, FL
  • NPI 1801018049

  Sports Physician

  NPD (past) Authorized official

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1982679825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1876 PIEDMONT PL",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467609",
            "telephone_number": "407-706-1420",
            "fax_number": "407-705-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "956 INTERNATIONAL PKWY STE 1580",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465219",
            "telephone_number": "407-706-1420",
            "fax_number": "407-705-3062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH0005746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harris Chiropractic Clinic Inc
• Jack Kirschenfeld Harris
• Janet Ruth Harris, PT
• Kayla Harris
• Kristin Harris
• Tarryn Harris
• Virginia Harris, LMHC
• Kendrick Trey Harrison
• Paris Harrison, BEHAVIOR TECHNICIAN
• Rachael Leanne Hart

• Sports Physician Chiropractor in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Sports Physician Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.