Individual provider Active NPI

Tatiana Nakita Grant Hardy, NP-C

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1538511753
Registry record updated May 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5008623 Issued in NC
Practice address
2930 Forestville Rd
Raleigh, NC 27616-8774
Phone
(919) 235-6550
NPI assigned
Jul 12, 2016
Last updated
May 17, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5008623 NC Primary

Addresses

Primary practice location

2930 Forestville Rd
Raleigh, NC 27616-8774

Mailing address

PO Box 602195
Charlotte, NC 28260-2195
Phone (919) 350-0351

Other identifiers 1

IdentifierTypeStateIssuer
1538511753MedicaidNC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address thardy155171@directHISP.wakemed.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161004002771 NC Practitioner - Nurse Practitioner 3971891151 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

2930 Forestville Rd
Raleigh, NC 27616-8774
Phone (919) 235-6550

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5008623NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians LLC CurrentSince Jan 1, 2018 Accepting new patients
Wake Specialty Physicians, LLC CurrentSince Jan 1, 2018 Accepting new patients

Locations

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

2930 Forestville Rd
Raleigh, NC 27616
Phone (919) 235-6500

11640 Northpark Dr
Wake Forest, NC 27587
Phone (919) 234-4468

Interoperability endpoints

  • Direct secure messaging: thardy155171@directhisp.wakemed.org

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 3

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": "1468281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1538511753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2930 FORESTVILLE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168774",
            "telephone_number": "919-235-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "TATIANA",
        "middle_name": "NAKITA GRANT",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-12",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1538511753",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "thardy155171@directHISP.wakemed.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "XML",
            "address_1": "2930 Forestville Rd",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276168774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.