Individual provider Active NPI

Paul Arthur Hardy Jr., LDO

  • Optician
  • Simpsonville, SC
National Provider Identifier
1629669676
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
943 Issued in SC
Practice address
412 Aschoff CT
Simpsonville, SC 29680-7921
Phone
(864) 918-0639
NPI assigned
Feb 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 943 SC
Optician 156FX1800X 943 SC Primary

Addresses

Primary practice location

412 Aschoff CT
Simpsonville, SC 29680-7921

Mailing address

412 Aschoff CT
Simpsonville, SC 29680-7921
Phone (864) 918-0639

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL www.provision2go.com Direct

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
943SCMDEyewear Supplier

NPI Registry JSON

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1629669676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 ASCHOFF CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807921",
            "telephone_number": "864-918-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 ASCHOFF CT",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296807921",
            "telephone_number": "864-918-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "PAUL",
        "middle_name": "ARTHUR",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "SC",
            "license": "943",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "SC",
            "license": "943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.provision2go.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "412 Aschoff Ct",
            "city": "Simpsonville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296807921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Simpsonville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.