Individual provider Active NPI

Joanna Michelle Hardy, FNP

  • Family Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1174636195
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R803993 Issued in MS
Practice address
2117 Broadway Drive
Hattiesburg, MS 39402-3210
Phone
(601) 288-8050
Fax
(601) 288-8058
NPI assigned
Aug 16, 2006
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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 R803993 MS Primary

Addresses

Primary practice location

2117 Broadway Drive
Hattiesburg, MS 39402-3210

Mailing address

2117 Broadway Drive
Hattiesburg, MS 39402-3210
Phone (601) 288-8050

Other identifiers 2

IdentifierTypeStateIssuer
891010340MedicaidAL
09483506MedicaidMS

Other names 1

  • Joanna Hardy Thoms Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20050922000917 MS Practitioner - Nurse Practitioner 6800783291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forrest County General HospitalGroup PAC ID 1052397767, 107 clinicians

Practice addresses (Care Compare)

1 Lincoln Pkwy
Hattiesburg, MS 39402-3262
Phone (601) 288-8050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Forrest County General Hospital CurrentSince Jan 1, 2022 Accepting new patients
Forrest County General Hospital CurrentSince Jan 1, 2022 Accepting new patients
South Mississippi Health Service, Inc Family Past Accepting new patients
Robert L Smoak Past Accepting new patients
Robert L Smoak Past Accepting new patients

Locations

1 Lincoln Pkwy
Ste 202
Hattiesburg, MS 39402
Phone (601) 288-8050

2117 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-8050

2255 Broadway Dr
Hattiesburg, MS 39402
Phone (601) 288-2273

Organizations & group practices 5

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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1174636195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2117 BROADWAY DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023210",
            "telephone_number": "601-288-8050",
            "fax_number": "601-288-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2117 BROADWAY DRIVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023210",
            "telephone_number": "601-288-8050",
            "fax_number": "601-288-8058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "JOANNA",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R803993",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891010340",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09483506",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "HARDY THOMS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.