NPIMap

Individual provider Active NPI

James Carlton Hardwick III, M.D.

  • Cardiovascular Disease Physician
  • Gulfport, MS
National Provider Identifier
1437130911
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
17874 Issued in MS
Practice address
4215 15TH St
Gulfport, MS 39501
Phone
(228) 863-5211
Fax
(228) 863-4101
NPI assigned
Nov 10, 2005
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 17874 MS Primary

Addresses

Primary practice location

4215 15TH St
Gulfport, MS 39501

Mailing address

PO Box 1810
Gulfport, MS 39502
Phone (228) 575-1194

Other identifiers 1

IdentifierTypeStateIssuer
1575534MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040124000163 LA Practitioner - Cardiovascular Disease (Cardiology) 8729980230 Reassigns benefits to 1 organization
I20190319000248 MS Practitioner - Cardiovascular Disease (Cardiology) 8729980230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Wake Forest University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4215 15TH St
Gulfport, MS 39501-2523
Phone (228) 863-5211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17874MSMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Cardiovascular Disease CurrentSince Nov 21, 2018 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Nov 21, 2018 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Lakeview Regional Physician Group LLC Past Accepting new patients

Locations

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4215 15th St
Gulfport, MS 39501
Phone (228) 863-5211

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

859 Winter St
Lucedale, MS 39452
Phone (601) 766-4286

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 62

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 62

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1437130911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39502",
            "telephone_number": "228-575-1194",
            "fax_number": "228-575-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 15TH ST",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-863-5211",
            "fax_number": "228-863-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDWICK",
        "first_name": "JAMES",
        "middle_name": "CARLTON",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "17874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1575534",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.