Amy Winterbotham Hardman, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

ME 76418 Issued in FL

Practice address

2121 Park St
Jacksonville, FL 32204-3811

Phone

(904) 387-6200

Fax

(904) 387-0261

NPI assigned

Aug 23, 2005

Last updated

Feb 13, 2017By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Im Sulzbacher Center for the Homeless, Inc

  dba Sulzbacher Center

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1710051354
  Medicare reassignment NPD
• University of Florida Jacksonville Physicians, Inc.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1144276452

  Pediatrics

  Medicare reassignment NPD
• Im Sulzbacher Center for the Homeless, Inc

  dba Sulzbacher Village Pediatric Health

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1396369187

  Pediatrics

  NPD
• University of Florida Jacksonville Physicians Inc

  • Developmental - Behavioral Pediatrics Physician
  • Jacksonville, FL
  • NPI 1649430919
  NPD
• University of Florida Jacksonville Physicians, Inc.

  dba UF Health Imaging Center-Baymeadows

  • Physiological Laboratory
  • Jacksonville, FL
  • NPI 1831800952
  NPD

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1629061932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043811",
            "telephone_number": "904-387-6200",
            "fax_number": "904-387-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043811",
            "telephone_number": "904-387-6200",
            "fax_number": "904-387-0261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDMAN",
        "first_name": "AMY",
        "middle_name": "WINTERBOTHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME 76418",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME76418",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259018200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• June G Harding, LCSW
• Katherine A Harding, MD
• Angel Hardison
• Tes Ashton Nicole Hardison, DC
• Jeremiah Hardisty
• Danielle Hardwick, LPN
• Jason Mitchell Hardwick, D.O.
• Alex Blake Hardy
• Amber Hardy
• Jacquelyn Hardy, LCSW

• Pediatric Adolescent Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Adolescent Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.