Individual provider Active NPI

Erika Lyn Hardeen

  • Licensed Practical Nurse
  • Ballston Spa, NY
National Provider Identifier
1609330216
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
258182-1 Issued in NY
Practice address
113 Wood Rd
Ballston Spa, NY 12020-2217
Phone
(518) 321-6018
NPI assigned
Jan 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 258182-1 NY Primary

Addresses

Primary practice location

113 Wood Rd
Ballston Spa, NY 12020-2217

Mailing address

26 Knickerbocker St
Ballston Spa, NY 12020-1125
Phone (518) 859-8428

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
258182-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1548633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548633600000",
    "number": "1609330216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 KNICKERBOCKER ST",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120201125",
            "telephone_number": "518-859-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WOOD RD",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120202217",
            "telephone_number": "518-321-6018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEEN",
        "first_name": "ERIKA",
        "middle_name": "LYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-28",
        "last_updated": "2019-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "258182-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Spa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; 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.