Kendra Harris, is a medicare enrolled "Social Worker - Clinical" provider in Roseburg, Oregon. Her current practice location is
621 W Madrone St, Roseburg, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 492-0241.
Kendra Harris is licensed to practice in Oregon (license number L11849) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1871064311.
Healthcare Provider's Profile
| Full Name | Kendra Harris |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 621 W Madrone St, Roseburg, Oregon |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1871064311
- Provider Enumeration Date: 12/10/2018
- Last Update Date: 10/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 4082151121
- Enrollment ID: I20240806004334
Medical Identifiers
Medical identifiers for Kendra Harris such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871064311 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 18-04-05 (Oregon) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 175T00000X | Peer Specialist | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | L11849 (Oregon) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kendra Harris allows following entities to bill medicare on her behalf.
| Entity Name | Adapt |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720010549
PECOS PAC ID: 4587662887
Enrollment ID: O20061121000327 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kendra Harris is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kendra Harris,
Po Box 1121,
Roseburg, OR 97470-0254
Ph: () - | Kendra Harris,
621 W Madrone St,
Roseburg, OR 97470-3090
Ph: (541) 492-0241 |
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