NPIMap

Individual provider Active NPI

Cameron Kleck Hardy, DO

  • Emergency Medicine Physician
  • Coeur d'Alene, ID
National Provider Identifier
1316443583
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
O-1680 Issued in ID
Practice address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone
(208) 625-5700
Fax
(208) 625-5708
NPI assigned
Apr 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X O-1680 ID Primary

Addresses

Primary practice location

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Mailing address

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 625-5700

Other practice location 1

36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-4800

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address chardy669766@direct.multicare.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20220722001064 ID Practitioner - Emergency Medicine 2062768104 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kootenai Health IncGroup PAC ID 1355792276, 394 clinicians

Practice addresses (Care Compare)

1055 Riverside Ave
Orofino, ID 83544-9029
Phone (208) 476-5777

2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. CurrentSince Jul 12, 2022 Accepting new patients
Incyte Pathology, PLLC Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Kootenai Health, Inc. Emergency Medicine Current Accepting new patients
Kootenai Health, Inc. CurrentSince Jul 12, 2022 Accepting new patients

Locations

2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085

1300 E Mullan Ave
Ste 700
Post Falls, ID 83854
Phone (208) 625-5564

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1316443583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5700",
            "fax_number": "208-625-5708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-625-5700",
            "fax_number": "208-625-5708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36475 Five Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Livonia",
            "state": "MI",
            "postal_code": "481541971",
            "country_code": "US",
            "telephone_number": "734-655-4800",
            "fax_number": "734-655-2911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDY",
        "first_name": "CAMERON",
        "middle_name": "KLECK",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "O-1680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chardy669766@direct.multicare.org",
            "affiliation": "N",
            "address_1": "2003 Kootenai Health Way",
            "city": "Coeur D Alene",
            "state": "ID",
            "country_code": "US",
            "postal_code": "838146051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.