Individual provider Active NPI

John Calvin Hardy, O.D.

  • Optometrist
  • Grand Junction, CO
National Provider Identifier
1093808362
Registry record updated Aug 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 2453 Issued in CO
Practice address
2881 North Ave
Grand Junction, CO 81501-5064
Phone
(970) 241-0943
Fax
(970) 241-0215
NPI assigned
Oct 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 2453 CO Primary

Addresses

Primary practice location

2881 North Ave
Grand Junction, CO 81501-5064

Mailing address

729 Beaver LDG
Grand Junction, CO 81505-8683
Phone (970) 243-1138

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170821003043 CO Practitioner - Optometry 7416229778 Practice locations: Grand Junction, CO

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT 2453COMDOptometrist
2453COMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503187200000",
    "number": "1093808362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 BEAVER LDG",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815058683",
            "telephone_number": "970-243-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2881 NORTH AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815015064",
            "telephone_number": "970-241-0943",
            "fax_number": "970-241-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "JOHN",
        "middle_name": "CALVIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-01",
        "last_updated": "2017-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "OPT 2453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.