Individual provider Active NPI

Jonathan Mark Hardin, DO

  • Emergency Medicine Physician
  • Fairhope, AL
National Provider Identifier
1053871483
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.3244 Issued in AL
Practice address
750 Morphy Ave
Fairhope, AL 36532-1899
Phone
(251) 928-2375
NPI assigned
Mar 21, 2019
Last updated
Oct 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO82243 SC
Emergency Medicine Physician 207P00000X DO.3244 AL Primary

Addresses

Primary practice location

750 Morphy Ave
Fairhope, AL 36532-1899

Mailing address

750 Morphy Ave
Fairhope, AL 36532-1899
Phone (251) 928-2375

Other practice location 1

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Other practice location 2

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211119002484 SC Practitioner - Emergency Medicine 3870822950 Reassigns benefits to 2 organizations
I20230920003538 AL Practitioner - Emergency Medicine 3870822950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Alabama College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baldwin Emergency Physicians, P.C..Group PAC ID 4688627946, 52 clinicians

Practice addresses (Care Compare)

750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 928-2375

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO82243SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw CurrentSince Jan 10, 2022 Accepting new patients
Baldwin Emergency Physicians, P.C.. Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
McLeod Health Cheraw Emergency Medicine Current Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Dec 1, 2021 Accepting new patients

Locations

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

4000 Highway 9 E
Little River, SC 29566
Phone (843) 390-8100

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1053871483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321899",
            "telephone_number": "251-928-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321899",
            "telephone_number": "251-928-2375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724607",
            "country_code": "US",
            "telephone_number": "843-692-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295724607",
            "country_code": "US",
            "telephone_number": "843-692-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "JONATHAN",
        "middle_name": "MARK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "DO82243",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "DO.3244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.