Charles J Hardebeck, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

35047571 Issued in OH

Practice address

473 W 12TH Ave
Hlri, 2ND Floor
Columbus, OH 43210-1252

Phone

(614) 947-3700

Fax

(614) 947-3771

NPI assigned

May 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Osu Internal Medicine, LLC

  • Endoscopy Clinic/Center
  • Dublin, OH
  • NPI 1427127919
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1508869736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD",
            "address_2": "SUITE 385",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-947-3700",
            "fax_number": "614-947-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "473 W 12TH AVE",
            "address_2": "HLRI, 2ND FLOOR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101252",
            "telephone_number": "614-947-3700",
            "fax_number": "614-947-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEBECK",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "KY",
            "license": "21052",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35047571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64210529",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0545459",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harbor Heart Health LLC
• Patrick W Harbour, M.D.
• Jeffrey D Harbrecht, MD
• Matthew Taylor Harbrecht, MD
• Wesley Frank Hard, MD
• Justin Harden, BACHELORS OF SCIENCE
• Kyle Dennis Harden, CDCA
• Laura Harden, LISW
• McKenzie K. Harden, PA-C
• Raysheen Harden

• Cardiovascular Disease Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Cardiovascular Disease Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.