MICHAEL T HARRIS MD, PC (NPI# 1285621532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285621532 |
| Entity Type | Organization |
| Organization Name | MICHAEL T HARRIS MD, PC |
| Practice Address |
3422 S 15th E Idaho Falls ID 83404-8262 |
| Practice Telephone | 2085521222 |
| Practice Fax Number | 2085523377 |
| Mailing Telephone | 2085521222 |
| Mailing Fax Number | 2085523377 |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2008-11-22 |
| Authorized Official Name | DR. MICHAEL T HARRIS (OWNER/PRACTITIONER) |
| Authorized Official Telephone | 2085521222 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
M 6846 | ID | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 003729200 | 05 | |
| ID | RAILROAD MEDICARE | P00077360 | 01 |
| ID | BLUE SHEILD OF IDAHO | 000010000013 | 01 |
| ID | BLUE CROSS OF IDAHO | 72793 | 01 |
| Street Address |
3422 S 15TH E |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-8262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760044424 | Phillip Marlowe | Radiologic Technologist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2019-07-02 |
| 1215314968 | Hsiang-hua Wang | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2015-05-01 |
| 1114343985 | Kelly Stark | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2014-03-17 |
| 1912335738 | Family Resource Centers of America, Inc | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2013-10-15 |
| 1164712899 | Sawtooth Rehab, Pllc | Specialist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-04-14 |
| 1720387681 | Travis Scott Hull | Social Worker | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-03-17 |
| 1376877795 | David Aaron Petty | Allergy & Immunology | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-10-01 |
| 1235363169 | Maria Teresa Alvarado | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-05-06 |
| 1982841334 | Karen Elise Bender | Registered Nurse | 3422 S 15th E, The Healing Sanctuary, Idaho Falls, ID 83404-8262 | 2009-01-07 |
| 1861651812 | Michael Rex | Social Worker | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2008-06-05 |
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|---|---|---|---|---|
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| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
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| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
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| 1164837647 | Cannon Chiropractic | Clinic/Center | 2052 Jennie Lee Dr, Suite 4, Idaho Falls, ID 83404-7047 | 2014-06-24 |
| 1902048879 | Rencher Family Practice, Pa | Clinic/Center | 2610 Channing Way, Idaho Falls, ID 83404-7517 | 2009-03-24 |
| 1922287226 | Roger S. Brunt M.d. P.a. | Clinic/Center | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2007-11-02 |
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| City | IDAHO FALLS |
| Zip Code | 83404 |
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| 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.