Individual provider Active NPI

Sandra Hardiman, PT

  • Physical Therapist
  • Winnsboro, TX
National Provider Identifier
1467934042
Registry record updated Aug 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1055028
Practice address
406 S Main St
Winnsboro, TX 75494-3226
Phone
(903) 342-6790
NPI assigned
Aug 30, 2018
Last updated
Aug 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1055028 TX
Physical Therapist 225100000X 1055028 Primary

Addresses

Primary practice location

406 S Main St
Winnsboro, TX 75494-3226

Mailing address

1750 Holcomb Cir
Tyler, TX 75703-0823

Other practice location 1

1750 Holcomb Cir
Tyler, TX 75703-0823
Phone (903) 570-4167

Other identifiers 1

IdentifierTypeStateIssuer
1055028OtherTXPT LICENSE

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

LicenseStateTypeSpecialty
1055028TXMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1467934042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 HOLCOMB CIR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757030823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S MAIN ST",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943226",
            "telephone_number": "903-342-6790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1750 Holcomb Cir",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757030823",
            "country_code": "US",
            "telephone_number": "903-570-4167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARDIMAN",
        "first_name": "SANDRA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1055028",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": "1055028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "1055028",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnsboro, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.