Jeremy Alan Hardy, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5790 C1 Issued in AL

Practice address

18471 Wilters St
Robertsdale, AL 36567-6627

Phone

(251) 947-3636

Fax

(251) 947-3637

NPI assigned

Feb 3, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• W. Jason Northcutt, DMD, PC

  • General Practice Dentistry
  • Robertsdale, AL
  • NPI 1962757518
  NPD (past)

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

{
    "created_epoch": "1233619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280102400000",
    "number": "1124266887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18471 WILTERS ST",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "365676627",
            "telephone_number": "251-947-3636",
            "fax_number": "251-947-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18471 WILTERS ST",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "365676627",
            "telephone_number": "251-947-3636",
            "fax_number": "251-947-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "JEREMY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-03",
        "last_updated": "2010-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3371-06",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5790 C1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06377319",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeannie Lee Fleek, LPC
• Stacie Renee Franklin
• Leyla Mariel Gomez Olmedo, SLP
• Evie Hackney
• Nicole Hall, PHARMD
• Rachael Hartman, DPT
• Baylee Hathcock, FNP-C
• Amy Michelle Henderson, CCC-SLP
• Emily Faith Hobbs
• Jessica Houston, M.S., CCC-SLP

• General Practice Dentistry in Robertsdale, AL
• Providers in Robertsdale, AL by specialty
• General Practice Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.