Individual provider Active NPI

David Hardy, FNP-C

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1083149397
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP133881 Issued in TX
Practice address
1000 E 5TH St
Tyler, TX 75701-3346
Phone
(903) 596-3500
NPI assigned
Apr 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP133881 TX Primary

Addresses

Primary practice location

1000 E 5TH St
Tyler, TX 75701-3346

Mailing address

1000 E 5TH St
Tyler, TX 75701-3346
Phone (903) 596-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511001840 TX Practitioner - Nurse Practitioner 4284911611 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians
Whitehouse Premier Health and Wellness, LLCGroup PAC ID 4880131069, 2 clinicians

Practice addresses (Care Compare)

1000 E 5TH St
Suite 400
Tyler, TX 75701-3362
Phone (903) 596-3500

602 State Hwy 110 N
Whitehouse, TX 75791-3053
Phone (903) 521-3650

Hospital & facility affiliations

  • Ut Health East Texas Tyler Regional Hospital Hospital, Tyler, TX, CCN 450083
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP133881TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Whitehouse Premier Health and Wellness LLC Family CurrentSince Jun 12, 2024 Accepting new patients
Etmc Physician Group Inc. CurrentSince Mar 1, 2018 Accepting new patients
Starks Medical Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1000 S Beckham Ave
Tyler, TX 75701
Phone (903) 526-1068

1000 E 5th St
Ste 400
Tyler, TX 75701
Phone (903) 593-1749

1000 E 5th St
Tyler, TX 75701
Phone (903) 590-5000

602 State Highway 110 N
Whitehouse, TX 75791
Phone (903) 521-3650

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 and National Provider Directory roles.

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713398400000",
    "number": "1083149397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013346",
            "telephone_number": "903-596-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 5TH ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013346",
            "telephone_number": "903-596-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "DAVID",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-24",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP133881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.