NPIMap

Individual provider Active NPI

Fred E. Hardwicke, M.D.

  • Medical Oncology Physician
  • Childress, TX
National Provider Identifier
1194713248
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
H0428 Issued in TX
Practice address
1001 US Highway 83 N
Childress, TX 79201-2322
Phone
(940) 937-3636
Fax
(940) 937-9615
NPI assigned
Oct 12, 2005
Last updated
May 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X H0428 TX
Medical Oncology Physician 207RX0202X H0428 TX Primary

Addresses

Primary practice location

1001 US Highway 83 N
Childress, TX 79201-2322

Mailing address

100 Bella Vista St
Childress, TX 79201-2304
Phone (806) 778-2688

Other practice location 1

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8600

Other identifiers 11

IdentifierTypeStateIssuer
135619803MedicaidTX
63916MedicaidNM
77643MedicaidNM
135619804MedicaidTX
81321YOtherTXBC/BS
114565101MedicaidTX
114565100OtherTXFIRSTCARE COMMERCIAL
100166970AMedicaidOK
63916OtherNMPRESBYTERIAN COMMERCIAL
84210ZOtherTXHMO BLUE
A416OtherTRIWEST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090608000368 TX Practitioner - Medical OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 8325198609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical OncologyAlso: Internal Medicine
Education
University of Texas Medical School at Houston, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1001 US Hwy 83 N
Childress, TX 79201-2322
Phone (940) 937-3636

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Childress County Hospital District CurrentSince Jun 1, 2021 Accepting new patients
Childress County Hospital District CurrentSince Jun 1, 2021 Accepting new patients
Childress County Hospital District Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: fred.hardwicke@direct.myteamcare.com

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1194713248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BELLA VISTA ST",
            "city": "CHILDRESS",
            "state": "TX",
            "postal_code": "792012304",
            "telephone_number": "806-778-2688",
            "fax_number": "940-937-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 US HIGHWAY 83 N",
            "city": "CHILDRESS",
            "state": "TX",
            "postal_code": "792012322",
            "telephone_number": "940-937-3636",
            "fax_number": "940-937-9615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Indiana Ave",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794153364",
            "country_code": "US",
            "telephone_number": "806-775-8600",
            "fax_number": "806-775-8602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDWICKE",
        "first_name": "FRED",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "H0428",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "TX",
            "license": "H0428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135619803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63916",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77643",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135619804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "81321Y",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114565101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE COMMERCIAL",
            "identifier": "114565100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100166970A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN COMMERCIAL",
            "identifier": "63916",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO BLUE",
            "identifier": "84210Z",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "A416",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Childress, TX

Sources for this page

Verify at the official NPI Registry.