Individual provider Active NPI

Maurice Hardy

  • Student in an Organized Health Care Education/Training Program
  • Jacksonville, FL
National Provider Identifier
1124491352
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2005 Knight Lane BLDG H
Attn:Medical Staff Services Navy Mecine Support Command
Jacksonville, FL 32212
Phone
(202) 762-3194
NPI assigned
Nov 10, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2005 Knight Lane BLDG H
Attn:Medical Staff Services Navy Mecine Support Command
Jacksonville, FL 32212

Mailing address

6415 Reflection Dr Apt 202
San Diego, CA 92124-3167
Phone (909) 253-8785

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1124491352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 REFLECTION DR APT 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921243167",
            "telephone_number": "909-253-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H",
            "address_2": "ATTN:MEDICAL STAFF SERVICES NAVY MECINE SUPPORT COMMAND",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "202-762-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "MAURICE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.