Paul J. Tardy

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3735 Issued in SC

Legal business name

PAUL J. TARDY

Practice address

105 Serendipity Way # D
Lexington, SC 29072-6999

Phone

(803) 556-3911

Fax

(866) 887-4617

NPI assigned

Jul 3, 2008

Organization subpart

No

Name

Mr. Paul J. Tardy, OTR/LNPI 1619010857

Title

Owner - Occupational Therapist

Phone

(803) 556-3911

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul J. Tardy, OTR/L

  • Occupational Therapist
  • Lexington, SC
  • NPI 1619010857
  NPD Authorized official
• Jennifer Ann Tardy, CHN

  • Health Educator
  • Lexington, SC
  • NPI 1891582060

  Single Specialty

  NPD (past)

• PT the OT Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 26, 2016.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1003079534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SERENDIPITY WAY # D",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726999",
            "telephone_number": "803-556-3911",
            "fax_number": "866-887-4617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SERENDIPITY WAY # D",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290726999",
            "telephone_number": "803-556-3911",
            "fax_number": "866-887-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL J. TARDY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "TARDY",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER - OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "803-556-3911",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "099039",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11513654",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD  MEDICARE",
            "identifier": "P00393431",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "266140000",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD",
            "identifier": "AA49980",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7052332",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH2387",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PT the OT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Lexington, SC
• Occupational Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.