Johnny Kyle Hardeman II, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

249198 Issued in GA

Practice address

2819 Rusticwood Dr
Snellville, GA 30078-2849

Phone

(912) 541-4983

NPI assigned

Dec 23, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671753600000",
    "number": "1255043071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 RUSTICWOOD DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782849",
            "telephone_number": "912-541-4983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 RUSTICWOOD DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782849",
            "telephone_number": "912-541-4983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEMAN",
        "first_name": "JOHNNY",
        "middle_name": "KYLE",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-23",
        "last_updated": "2022-12-23",
        "certification_date": "2022-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "249198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Evelyn Hannigan, LPN
• Happy Teeth PC
• Ryan Harazim, RBT
• Ansley Hardbeck, RBT
• Alberta Hardeman
• Jessica Deana Harden
• Annasue Huys Hardin, FNP-C
• Badr Harfouch, MD
• Youstina Harkas
• Caressa Harp, LPC

• Psychiatric/Mental Health Registered Nurse in Snellville, GA
• Providers in Snellville, GA by specialty
• Psychiatric/Mental Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2022; 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.