Individual provider Active NPI

Mary A Hardie, CRNA

  • Certified Registered Nurse Anesthetist
  • Fredericksburg, TX
National Provider Identifier
1215904479
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
432601 Issued in TX
Practice address
415 S Washington St
Fredericksburg, TX 78624-4636
Phone
(830) 997-9170
Fax
(830) 997-9226
NPI assigned
Mar 7, 2006
Last updated
Nov 29, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 432601 TX Primary

Addresses

Primary practice location

415 S Washington St
Fredericksburg, TX 78624-4636

Mailing address

415 S Washington St
Fredericksburg, TX 78624-4636
Phone (830) 997-9170

Other identifiers 1

IdentifierTypeStateIssuer
83874UOtherTXBCBS TX

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)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
432601TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cole Physical Therapy Inc Past Accepting new patients
Anesthesia Consultants of Fredericksburg Past Accepting new patients
Anesthesia Healthcare Partners of Laredo, P. a. Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1215904479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S WASHINGTON ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244636",
            "telephone_number": "830-997-9170",
            "fax_number": "830-997-9226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S WASHINGTON ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244636",
            "telephone_number": "830-997-9170",
            "fax_number": "830-997-9226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDIE",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "432601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "83874U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.