Individual provider Active NPI

Robert B Hardy, DMD

  • General Practice Dentistry
  • Augusta, GA
National Provider Identifier
1639144868
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN012913 Issued in GA
Practice address
1722 Wylds Rd
Augusta, GA 30909-4353
Phone
(706) 736-1135
Fax
(706) 736-1186
NPI assigned
Feb 21, 2006
Last updated
Aug 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN012913 GA Primary

Addresses

Primary practice location

1722 Wylds Rd
Augusta, GA 30909-4353

Mailing address

2825 Washington Rd
Suite M2
Augusta, GA 30909-2119
Phone (706) 736-1135

Other identifiers 3

IdentifierTypeStateIssuer
9180179MedicaidGA
793669595AMedicaidGA
003141021AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jodie@drbenhardy.com Health Information Exchange (HIE)

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
DN012913GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
R. Ben Hardy, DMD, LLC General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1639144868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2825 WASHINGTON RD",
            "address_2": "SUITE M2",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092119",
            "telephone_number": "706-736-1135",
            "fax_number": "706-736-1186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1722 WYLDS RD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094353",
            "telephone_number": "706-736-1135",
            "fax_number": "706-736-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN012913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9180179",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "793669595A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003141021A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jodie@drbenhardy.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1722 Wylds Rd",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309094353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.