DR. KHEALYNN FERNELIUS HARRIS DMD
NPI 1083090567
Dentist - General Practice in Yelm, WA
About Dr. Khealynn Fernelius Harris Dmd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KHEALYNN FERNELIUS HARRIS DMD (NPI 1083090567) is an individual general practice provider in Yelm, Washington, licensed in Washington (DE60586603) and active in the NPI registry since August 2015. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Khealynn Fernelius Harris Dmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Khealynn Harris reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Hilo, HI 96720
- Reassigned Medicare billing, Hawaii enrollment
- Medicare enrollment name: Bay Clinic Inc
- 20 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 98597 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
YELM, WA 98597
YELM, WA 98597
YELM, WA 98597
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Khealynn Harris's NPI number?
The NPI number for Khealynn Harris is 1083090567. It was assigned to this individual provider in the NPPES registry on August 6, 2015.
Where is Khealynn Harris located?
Khealynn Harris practices at 202 Cullens St NW, Yelm, WA 98597. The listed phone number is (801) 857-8001.
What is Khealynn Harris's specialty?
The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.
Is Khealynn Harris enrolled in Medicare?
Yes. Khealynn Harris is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Khealynn Harris's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Khealynn Harris reassigns Medicare benefits to Whchc - Hawaii Island Community Health Center (Hilo, HI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Khealynn Harris's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Khealynn Harris accept?
Health plans from Hawaii Dental Service and Humana list Khealynn Harris as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Khealynn Harris was last updated on October 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Khealynn Fernelius Harris, DMD · NPI 1083090567
General Practice provider in Yelm, Washington. Individual provider, active in the CMS NPPES registry since August 6, 2015.
## Identity
- **NPI:** 1083090567 (Entity type: Individual)
- **Enumerated:** August 6, 2015
- **Primary specialty:** Dentist - General Practice · taxonomy 1223G0001X
- **State license:** DE60586603 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 202 CULLENS ST NW, Yelm, WA 98597-9417
- **Phone:** (801) 857-8001
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Whchc - Hawaii Island Community Health Center (NPI 1053955120, Hilo, HI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 19, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1083090567) · Data from the CMS NPPES public registry.