Individual provider Active NPI

Kianne Abraham Hardee, MD

  • Diagnostic Radiology Physician
  • Fort Worth, TX
National Provider Identifier
1407050693
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
N1513 Issued in TX
Practice address
815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone
(817) 321-0404
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X N1513 TX Primary

Addresses

Primary practice location

815 Pennsylvania Ave
Fort Worth, TX 76104-2224

Mailing address

816 W Cannon St
Fort Worth, TX 76104-3146
Phone (817) 321-0404

Other practice location 1

700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-2000

Other identifiers 1

IdentifierTypeStateIssuer
BP1-0026373OtherINSTITUTIONAL PERMIT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100802000079 TX Practitioner - Diagnostic Radiology 5698808343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Louisiana State University School of Medicine in Shreveport, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Radiology Associates of North Texas PAGroup PAC ID 7911897301, 340 clinicians

Practice addresses (Care Compare)

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0470

Hospital & facility affiliations

  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • Christus St Michael Health System Hospital, Texarkana, TX, CCN 450801
  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas, PA Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Radiology Associates of North Texas PA Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Clinical Care in Radiology Past Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

811 S Washington Ave
Marshall, TX 75670
Phone (903) 315-1488

Organizations & group practices 3

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 4

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1407050693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W CANNON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043146",
            "telephone_number": "817-321-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 PENNSYLVANIA AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042224",
            "telephone_number": "817-321-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015580",
            "country_code": "US",
            "telephone_number": "903-315-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDEE",
        "first_name": "KIANNE",
        "middle_name": "ABRAHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "N1513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSTITUTIONAL PERMIT",
            "identifier": "BP1-0026373",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.