NPIMap

Individual provider Active NPI

Stacy Hardy, MD

  • Internal Medicine Physician
  • McAlester, OK
National Provider Identifier
1396708517
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
17060 Issued in OK
Practice address
1401 E Van Buren Ave
McAlester, OK 74501-4245
Phone
(918) 426-0240
Fax
(918) 423-4051
NPI assigned
Apr 10, 2006
Last updated
Apr 14, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 17060 OK Primary

Addresses

Primary practice location

1401 E Van Buren Ave
McAlester, OK 74501-4245

Mailing address

PO Box 908
McAlester, OK 74502-0908
Phone (918) 426-0240

Other identifiers 6

IdentifierTypeStateIssuer
1324230001OtherOKPALMETTO DME
731310891028OtherOKTRICARE SOUTH
731310891006OtherOKUNICARE
E27646OtherOKSTERLING OPTION 1
74502A015OtherOKCHAMPUS (WPS)
0166707OtherOKUMWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20091218000402 OK Practitioner - Internal Medicine 2365582541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Texas Medical School at San Antonio, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

1401 E Van Buren Ave
McAlester, OK 74501-4245
Phone (918) 426-0240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17060OKMDInternal Medicine Physician
1760OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Jan 1, 1998 Accepting new patients
Walnut Healthcare, LLC Past Accepting new patients

Locations

1401 E Van Buren Ave
McAlester, OK 74501
Phone (918) 421-8440

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: shardy7667@direct.saintfrancis.com

Organizations & group practices 2

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 9

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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1396708517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 908",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745020908",
            "telephone_number": "918-426-0240",
            "fax_number": "918-423-4051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E VAN BUREN AVE",
            "city": "MCALESTER",
            "state": "OK",
            "postal_code": "745014245",
            "telephone_number": "918-426-0240",
            "fax_number": "918-423-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "STACY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "17060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO DME",
            "identifier": "1324230001",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "731310891028",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNICARE",
            "identifier": "731310891006",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STERLING OPTION 1",
            "identifier": "E27646",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS (WPS)",
            "identifier": "74502A015",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "0166707",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAlester, OK

Sources for this page

Verify at the official NPI Registry.