DEREK R. HARRIS (NPI# 1821360728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821360728 |
| Entity Type | Individual |
| Full Name | DEREK R. HARRIS |
| Credential | MSN, APRN, CPNP-PC |
| Practice Address |
1919 Fairfield Ave Shreveport LA 71101-4436 |
| Practice Telephone | 3188282210 |
| Practice Fax Number | 3188282215 |
| Mailing Telephone | 3188282210 |
| Mailing Fax Number | 3188282215 |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2019-06-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
AP07181 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2330578 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922545094 | Derek Harris | Counselor | 122 S Michigan Ave, Suite 406, Chicago, IL 60603-6191 | 2017-01-26 |
| 1982969333 | Derek Harris | Counselor | 216 N 3rd St, Sterling, CO 80751-4302 | 2012-07-11 |
| 1083997571 | Derek J Harris | Pharmacist | 1301 Bell Rd, Antioch, TN 37013-3730 | 2011-09-21 |
| Street Address |
1919 FAIRFIELD AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699769026 | Amanda Lynn Kampert | Pediatrics | 1919 Fairfield Ave, Shreveport, LA 71101-4436 | 2005-08-31 |
| 1447810973 | Ashley C Viviano | Nurse Practitioner | 1919 Fairfield Ave, Shreveport, LA 71101-4436 | 2019-06-17 |
| 1942573589 | Progressive Childrens Clinic LLC | Pediatrics | 1919 Fairfield Ave, Shreveport, LA 71101 | 2012-02-13 |
| 1023219953 | Maria Delosangeles Arroyo | Specialist | 1919 Fairfield Ave, Shreveport, LA 71101-4436 | 2007-05-29 |
| 1306913892 | Heart Center Cardiovascular Specialists | Specialist | 1919 Fairfield Ave, Shreveport, LA 71101-4436 | 2006-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376092510 | Tanquenika Markray | Nurse Practitioner | 351 Hearne Ave, Shreveport, LA 71103-2019 | 2016-09-29 |
| 1619226727 | Micah Boyett Pilcher | Nurse Practitioner | 9220 Ellerbe Rd Ste 700, Shreveport, LA 71106-6709 | 2012-09-05 |
| 1568489342 | Margaret S Raish | Nurse Practitioner | 410 W. 70th Street, Linwood School Based Health Center, Shreveport, LA 71106 | 2006-07-16 |
| 1568015584 | Lori J Phillips | Nurse Practitioner | 909 Olive St, Shreveport, LA 71104-2103 | 2019-07-18 |
| 1447810973 | Ashley C Viviano | Nurse Practitioner | 1919 Fairfield Ave, Shreveport, LA 71101-4436 | 2019-06-17 |
| 1104311778 | Amanda Carfagno | Nurse Practitioner | 3100 Samford Ave, Shreveport, LA 71103-4239 | 2018-06-26 |
| 1528583549 | Jennipher Lyn Smothers | Nurse Practitioner | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2017-08-10 |
| 1598137374 | Jamiee Brice | Nurse Practitioner | 2520 Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71118-3130 | 2015-10-20 |
| 1336516533 | Holly Rivers | Nurse Practitioner | 2520 Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71118-3130 | 2015-08-24 |
| 1639545692 | Angela Moyer | Nurse Practitioner | 2520 Bert Kouns Industrial Loop, Suite 105, Shreveport, LA 71118-3130 | 2015-08-13 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on DEREK R. HARRIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.