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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NEELY TAYLOR ROSE HARRIS MD
NPI 1962029579
Pediatrics in Lake St Louis, MO

Active since June 30, 2020PECOS Enrolled
100 MEDICAL PLZ, LAKE ST LOUIS, MO 63367(636) 625-5200 Get Directions Write a Review

NPPES record last updated: October 5, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 5, 2026, Oct 30, 2023, Jun 30, 2020 (3 updates tracked since 2020).

About Neely Taylor Rose Harris Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEELY TAYLOR ROSE HARRIS MD (NPI 1962029579) is an individual pediatrics provider in Lake St Louis, Missouri, licensed in Illinois (036-166678) and active in the NPI registry since June 2020. She is enrolled in Medicare PECOS and maintains a secondary practice location in Pana.

NPPES Registry Identity

NPI1962029579
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameNEELY TAYLOR ROSE HARRISCredential: MD
Location Address100 MEDICAL PLZLake St Louis, MO 63367-1366
Mailing Address230 N 2625 East RdPana, IL 62557-6642
Phone(636) 625-5200
Sole ProprietorNo
Enumeration DateJune 30, 2020
Last NPPES UpdateOctober 5, 20263 updates tracked since enumeration
NPPES CertifiedOctober 5, 2026
✔ NPI 1962029579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in IL · 036-166678✔ Licensed in MO · 2020018778
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
100 MEDICAL PLZ, Lake St Louis, MO 63367
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Secondary Practice Location 1

Location 1230 N 2625 East RdPana, IL 62557-6642 · Phone (217) 820-5247

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Neely Taylor Rose Harris Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Neely Harris reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Ssm Health Care St. Louis
Same address
Emergency Medical Services
100 MEDICAL PLZ
Lake St Louis, MO 63367
  • Reassigned Medicare billing, Missouri enrollment
  • 741 clinicians in this Medicare group
NPI 1538113097 (636) 625-5200
Sarah Bush Lincoln Health Center
91 mi
Skilled Nursing Facility
650 W TAYLOR ST
Vandalia, IL 62471
  • Reassigned Medicare billing, Illinois enrollment
  • 652 clinicians in this Medicare group
NPI 1306959689 (618) 283-1232

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 63367 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

VICTORIA LYNN HINES NP
Nurse Practitioner
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200
LAKE FOREST EMERGENCY GROUP LLC
Emergency Medicine
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200
EVE WEINDELL BARNOSKI LPTA
Physical Therapy Assistant
100 MEDICAL PLZ
LAKE SAINT LOUIS, MO 63367
St. Charles County (636) 485-7608
JOSHUA HARKLESS MD
Emergency Medicine
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5300
MELISSA COLLEEN HYNES MHS, CCC-SLP
Speech-Language Pathologist
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 755-3997
AKIKO OKABE AGACNP
Nurse Practitioner (Acute Care)
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (314) 317-0600
KENDRICK J WILLIAMS MD
Pediatrics
100 MEDICAL PLZ
LAKE SAINT LOUIS, MO 63367
St. Charles County (636) 625-5300
YUNHEE CHOI CRUSE CNP, FNP-BC
Nurse Practitioner (Family)
100 MEDICAL PLZ
LAKE ST LOUIS, MO 63367
St. Charles County (636) 625-5200

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 Neely Harris's NPI number?

The NPI number for Neely Harris is 1962029579. It was assigned to this individual provider in the NPPES registry on June 30, 2020.

Where is Neely Harris located?

Neely Harris practices at 100 Medical Plz, Lake St Louis, MO 63367. The listed phone number is (636) 625-5200.

What is Neely Harris's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Neely Harris enrolled in Medicare?

Yes. Neely Harris is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Neely Harris's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Neely Harris reassigns Medicare benefits to 2 organizations: Ssm Health Care St. Louis (Lake St Louis, MO) and Sarah Bush Lincoln Health Center (Vandalia, IL). Each 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 Neely Harris's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Neely Harris was last updated on October 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days 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.