Active NPI
Dasha Hardin, RD, LD
- Registered Dietitian
- Martinez, GA
National Provider Identifier
1316664626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD006313
- Practice address
- 4318 Thrush CT
Martinez, GA 30907-4415 - Phone
- (850) 624-2583
- NPI assigned
- Oct 26, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD006313 | GA | Primary |
Addresses
Primary practice location
4318 Thrush CT
Martinez, GA 30907-4415
Mailing address
4318 Thrush CT
Martinez, GA 30907-4415
Phone (850) 624-2583
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD006313 | GA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Broad Wellness, LLC | Dietitian, Registered | Current | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666742400000",
"number": "1316664626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4318 THRUSH CT",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309074415",
"telephone_number": "850-624-2583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4318 THRUSH CT",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "309074415",
"telephone_number": "850-624-2583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDIN",
"first_name": "DASHA",
"credential": "RD, LD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-10-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD006313",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.