1982826921 NPI number — RACHEL ROSENBERG HARRIS D.O.

Table of content: RACHEL ROSENBERG HARRIS D.O. (NPI 1982826921)

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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