NPIMap

Organization Active NPI

Lance E Hardison DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Oklahoma City, OK
National Provider Identifier
1639248149
Registry record updated Nov 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
151 Issued in OK
Legal business name
LANCE E HARDISON DPM PC
Practice address
1126 S.W. 89
Oklahoma City, OK 73139-9104
Phone
(405) 692-7114
Fax
(405) 692-2425
NPI assigned
Nov 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2022

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

Authorized official

Name
Lance E Hardison, DPMNPI 1407084155
Title
Owner of Corp
Phone
(405) 751-6153

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 151 OK Primary

Addresses

Primary practice location

1126 S.W. 89
Oklahoma City, OK 73139-9104

Mailing address

1126 S.W. 89
Oklahoma City, OK 73139-9104
Phone (405) 692-7114

Other names 1

  • Michael K Wilson DPM Inc (other name) Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040715001346 OK Part B Supplier - Clinic/Group Practice 4688653348 Receives reassigned benefits from 3 practitioners
Practice locations: Oklahoma City, OK
O20100930092378 OK DME Supplier - Physician - Podiatry 4688653348 Practice locations: Oklahoma City, OK

National Provider Directory

National Provider Directory
Tax ID family
Michael K Wilson DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1126 SW 89th St
Oklahoma City, OK 73139
Phone (405) 692-7114

1044 SW 44th St
Ste 102
Oklahoma City, OK 73109
Phone (405) 631-9657

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1639248149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1126 S.W. 89",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399104",
            "telephone_number": "405-692-7114",
            "fax_number": "405-692-2425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 S.W. 89",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731399104",
            "telephone_number": "405-692-7114",
            "fax_number": "405-692-2425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCE E HARDISON DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "HARDISON",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER OF CORP",
        "authorized_official_telephone_number": "405-751-6153",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michael K Wilson DPM Inc (other name)",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.