Individual provider Active NPI

Michael Cole Hardwick, DPT

  • Physical Therapist
  • Flagstaff, AZ
National Provider Identifier
1104415413
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-010322 Issued in AZ
Practice address
77 W Forest Ave Ste 301
Flagstaff, AZ 86001-1483
Phone
(928) 773-2280
NPI assigned
Jan 12, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-010322 AZ Primary

Addresses

Primary practice location

77 W Forest Ave Ste 301
Flagstaff, AZ 86001-1483

Mailing address

3250 S Hunter PL
Flagstaff, AZ 86005-8948
Phone (619) 251-1591

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1104415413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 S HUNTER PL",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860058948",
            "telephone_number": "619-251-1591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 301",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "928-773-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDWICK",
        "first_name": "MICHAEL",
        "middle_name": "COLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-010322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.