Individual provider Active NPI

Racheal Hardin, NP

  • Nurse Practitioner
  • Webster, TX
National Provider Identifier
1104601301
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP139515 Issued in TX
Practice address
17080 Highway 3
Webster, TX 77598-4129
Phone
(281) 557-5525
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP139515 TX Primary

Addresses

Primary practice location

17080 Highway 3
Webster, TX 77598-4129

Mailing address

120 Sacajewa Dr
La Marque, TX 77568-6628
Phone (409) 739-1099

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
I20240604002907 TX Practitioner - Nurse Practitioner 0042752123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Galveston Physical Medicine PLLCGroup PAC ID 1557519741, 3 clinicians

Practice addresses (Care Compare)

2724 61St St
Suite 5
Galveston, TX 77551-1800
Phone (409) 744-9355

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Oaks Physical Medicine, PLLC CurrentSince Sep 5, 2023 Accepting new patients
Galveston Physical Medicine PLLC CurrentSince Apr 20, 2024 Accepting new patients
Duchon Chiropractic PastSince Apr 20, 2024 Accepting new patients
David a. Potts, D.C. PastSince Sep 5, 2023 Accepting new patients

Locations

2724 61st St
Ste 5
Galveston, TX 77551
Phone (409) 744-9355

17080 Highway 3
Webster, TX 77598
Phone (281) 557-5525

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.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1104601301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SACAJEWA DR",
            "city": "LA MARQUE",
            "state": "TX",
            "postal_code": "775686628",
            "telephone_number": "409-739-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17080 HIGHWAY 3",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984129",
            "telephone_number": "281-557-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIN",
        "first_name": "RACHEAL",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP139515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.