Active NPI
Dale A Hardy, CNM
- Obstetrics & Gynecology Physician
- Fairbanks, AK
National Provider Identifier
1639106453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 203233-4402
- Practice address
- 1919 Lathrop St
#217
Fairbanks, AK 99701-5937 - Phone
- (907) 456-8191
- Fax
- (907) 456-8192
- NPI assigned
- Jun 27, 2006
- Last updated
- Oct 15, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 203233-4402 | UT | Primary |
Addresses
Primary practice location
1919 Lathrop St
#217
Fairbanks, AK 99701-5937
Mailing address
1919 Lathrop St
#217
Fairbanks, AK 99701-5937
Phone (907) 456-8191
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1131 | AK | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Generations OB/GYN PC | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Obstetrics & Gynecology Physician
- Layton, UT
- NPI 1407866429
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255564800000",
"number": "1639106453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 LATHROP ST",
"address_2": "#217",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015937",
"telephone_number": "907-456-8191",
"fax_number": "907-456-8192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 LATHROP ST",
"address_2": "#217",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015937",
"telephone_number": "907-456-8191",
"fax_number": "907-456-8192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDY",
"first_name": "DALE",
"middle_name": "A",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2009-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "UT",
"license": "203233-4402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.