CARSON R HARRIS (NPI# 1598730152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598730152 |
| Entity Type | Individual |
| Full Name | CARSON R HARRIS |
| Credential | MD |
| Practice Address |
8040 Old Cedar Ave S Ste 100 Bloomington MN 55425-1205 |
| Mailing Address |
8100 34th Ave S Mc21110q Bloomington MN 55425-1672 |
| Practice Telephone | 6512543456 |
| Practice Fax Number | 6512545216 |
| Mailing Telephone | 9528837172 |
| Mailing Fax Number | 9528835395 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2019-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 31091 | MN | Allopathic & Osteopathic Physicians |
| Y | 2083A0300X | 31091 | MN |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 53585100 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1730 Clifton Pl, Minneapolis, MN 554033242 | 6128131581 | 6128712154 |
| Street Address |
8040 OLD CEDAR AVE S STE 100 |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55425-1205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194230045 | Patricia Joann Friedman | Counselor | 8040 Old Cedar Ave S Ste 100, Bloomington, MN 55425-1205 | 2017-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275132003 | Faizo A Hersi | Student in an Organized Health Care Education/Training Program | 9700 International Dr Suite 300, Bloomington, MN 55425 | 2020-10-22 |
| 1134773419 | Fairview Clinics | Clinic/Center | 322 E. Broadway Suite E322, Bloomington, MN 55425 | 2019-07-25 |
| 1548730328 | Che Doua Thao | Pharmacy Technician | Leafline Labs, Eagan, MN 55425 | 2018-12-05 |
| 1235645763 | Caringhands Adult Day Center | Chore Provider | 8040 Old Cedar Ave South Suite # 1, Bloomington, MN 55425 | 2017-12-20 |
| 1174044119 | Abs Holdings, Inc. | In Home Supportive Care | 2626 East 82nd St., Suite 145, Bloomington, MN 55425 | 2017-06-29 |
| 1598144891 | Matthew Runde | Family Medicine | Riverway Clinic Anoka 601 Jacob Lane, Anoka, MN 55425 | 2015-05-20 |
| 1336578145 | Rebecca Ann Lund | Counselor | 8011 34th Avenue South, Suite 206, Bloomington, MN 55425 | 2013-11-02 |
| 1578902250 | Promise Care, Inc | Home Health | 7900 International Drive, Suite 300, Bloomington, MN 55425 | 2013-06-17 |
| 1336292911 | Gane Marie Boothroyd | Optometrist | 304 N. Garden, Mall of America, Bloomington, MN 55425 | 2007-01-18 |
| 1841341898 | Visual Edge, Inc | Technician/Technologist | W 385 West Market, Mall of America, Bloomington, MN 55425 | 2007-01-16 |
| Find all providers in zip 55425 | ||||
| City | BLOOMINGTON |
| Zip Code | 55425 |
Please comment or provide details below to improve the information on CARSON 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.