Individual provider Active NPI

Amanda Hardy, CRNP

  • Family Nurse Practitioner
  • Alexander City, AL
National Provider Identifier
1174051643
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-136075 Issued in AL
Practice address
1120 Airport Dr
Alexander City, AL 35010-3436
Phone
(256) 212-9300
NPI assigned
May 30, 2017
Last updated
May 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-136075 AL Primary

Addresses

Primary practice location

1120 Airport Dr
Alexander City, AL 35010-3436

Mailing address

16546 Highway 280
Dadeville, AL 36853-2528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180716002985 AL Practitioner - Nurse Practitioner 0244587723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Basel Refai MD PCGroup PAC ID 2769433903, 4 clinicians

Practice addresses (Care Compare)

1825 Halcyon Blvd
Montgomery, AL 36117-8044
Phone (256) 212-9300

815 Lee St
Alexander City, AL 35010-3444
Phone (256) 212-9300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-136075ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Basel Refai MD PC Single Specialty CurrentSince Jul 10, 2018 Accepting new patients
Temple Medical Clinic, PC Single Specialty Past Accepting new patients

Locations

1120 Airport Dr
Ste 102
Alexander City, AL 35010
Phone (256) 212-9300

1825 Halcyon Blvd
Montgomery, AL 36117
Phone (256) 212-9300

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/65979035-1557-4261-8de9-caa332ef8187/
  • FHIR API: https://fhir4.healow.com/fhir/r4/EGGBDA

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1174051643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16546 HIGHWAY 280",
            "city": "DADEVILLE",
            "state": "AL",
            "postal_code": "368532528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 AIRPORT DR",
            "city": "ALEXANDER CITY",
            "state": "AL",
            "postal_code": "350103436",
            "telephone_number": "256-212-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "AMANDA",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-30",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-136075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexander City, AL

Sources for this page

Verify at the official NPI Registry.