NPIMap

Individual provider Active NPI

Kelly Renee Hardesty, NP

  • Family Nurse Practitioner
  • Kouts, IN
National Provider Identifier
1265957971
Registry record updated Aug 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28187389A Issued in IN
Practice address
703 N Main St
Kouts, IN 46347-9692
Phone
(219) 766-3131
NPI assigned
Aug 3, 2017
Last updated
Aug 3, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 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 28187389A IN Primary

Addresses

Primary practice location

703 N Main St
Kouts, IN 46347-9692

Mailing address

401 Ross Ave
Kouts, IN 46347-9560
Phone (219) 678-7714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180321002666 IN Practitioner - Nurse Practitioner 5092077511 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
Infectious Disease Specialists PCGroup PAC ID 4981691862, 12 clinicians

Practice addresses (Care Compare)

2701 Leonard Dr
Suite B
Valparaiso, IN 46383-7121
Phone (219) 972-1547

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.1 of 100Reported as group
Quality
70.56
Improvement activities
40
Cost
72.91

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28187389AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Disease Specialists PC CurrentSince Jun 23, 2018 Accepting new patients

Locations

200 E 86th Pl
Merrillville, IN 46410
Phone (219) 649-2750

2701 Leonard Dr
#A
Valparaiso, IN 46383
Phone (219) 464-9800

2701 Leonard Dr
#B
Valparaiso, IN 46383
Phone (219) 464-9800

Interoperability endpoints

  • Direct secure messaging: khardesty29752@themethodisthospitals.direct-ci.com

Organizations & group practices 1

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 10

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": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501718400000",
    "number": "1265957971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 ROSS AVE",
            "city": "KOUTS",
            "state": "IN",
            "postal_code": "463479560",
            "telephone_number": "219-678-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 N MAIN ST",
            "city": "KOUTS",
            "state": "IN",
            "postal_code": "463479692",
            "telephone_number": "219-766-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDESTY",
        "first_name": "KELLY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28187389A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kouts, IN

Sources for this page

Verify at the official NPI Registry.