1982826921 NPI number — RACHEL ROSENBERG HARRIS D.O.

Table of content: (NPI 1306632757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982826921 NPI number — RACHEL ROSENBERG HARRIS D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARRIS
Provider First Name:
RACHEL
Provider Middle Name:
ROSENBERG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
RACHEL
Provider Other Middle Name:
ROSENBERG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DO
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982826921
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 360
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SYLVA
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28779-0360
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-339-6065
Provider Business Mailing Address Fax Number:
828-538-4441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 N KING ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HENDERSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28792-4349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-693-3344
Provider Business Practice Location Address Fax Number:
855-308-2340
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  2007-00637 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CS2119400406 . This is a "CARESOURCE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: NC7264C . This is a "MEDICARE PTAN-LFM" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: P02132559 . This is a "RAILROAD MEDICARE-LFM" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 1463M . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 5907279 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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