Individual provider Active NPI

Charlotte Ann Hardesty, APRN

  • Gerontology Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1104504398
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4006778 Issued in KY
Practice address
4000 Kresge Way
Louisville, KY 40207-4605
Phone
(502) 897-8100
NPI assigned
Jul 7, 2023
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4006778 KY
Gerontology Nurse Practitioner 363LG0600X 4006778 KY Primary

Addresses

Primary practice location

4000 Kresge Way
Louisville, KY 40207-4605

Mailing address

4217 Mimosa View Dr
Louisville, KY 40299-5817
Phone (502) 553-0988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230816002968 KY Practitioner - Nurse Practitioner 4486016839 Reassigns benefits to 1 organization
I20231019002630 IN Practitioner - Nurse Practitioner 4486016839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

1850 State St
New Albany, IN 47150-4990
Phone (812) 542-4921

3900 Kresge Way
Suite 51
Louisville, KY 40207-4690
Phone (502) 259-5955

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4006778KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Nurse Practitioner Current Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Aug 2, 2023 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 2, 2023 Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1850 State St
New Albany, IN 47150
Phone (812) 944-7701

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

3900 Kresge Way
Ste 51
Louisville, KY 40207
Phone (502) 259-5955

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

4000 Kresge Way
St Matthews, KY 40207
Phone (502) 459-7902

Organizations & group practices 3

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1104504398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4217 MIMOSA VIEW DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402995817",
            "telephone_number": "502-553-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074605",
            "telephone_number": "502-897-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDESTY",
        "first_name": "CHARLOTTE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4006778",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "4006778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.