Individual provider Active NPI

Jean Marie Hardy, REGISTERED NURSE

  • Registered Nurse
  • North Patchogue, NY
National Provider Identifier
1053500397
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4040221 Issued in NY
Practice address
10 Hill St
North Patchogue, NY 11772
Phone
(631) 654-8927
NPI assigned
Oct 23, 2007
Last updated
Oct 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4040221 NY Primary

Addresses

Primary practice location

10 Hill St
North Patchogue, NY 11772

Mailing address

10 Hill St
North Patchogue, NY 11772
Phone (631) 654-8927

Other names 1

  • Jeannie Micha Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4040221NYMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1053500397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 HILL ST",
            "city": "NORTH PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-654-8927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 HILL ST",
            "city": "NORTH PATCHOGUE",
            "state": "NY",
            "postal_code": "11772",
            "telephone_number": "631-654-8927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-23",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "4040221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNIE",
            "last_name": "MICHA",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2007; 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.