Individual provider Active NPI

Wanda S Hardy, CASEMANAGER

  • Case Manager/Care Coordinator
  • Statesville, NC
National Provider Identifier
1649594235
Registry record updated Mar 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
000000000 Issued in NC
Practice address
1119 McLaughlin St
Statesville, NC 28677-6862
Phone
(704) 838-0941
Fax
(704) 838-0330
NPI assigned
Mar 25, 2010
Last updated
Mar 25, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 000000000 NC Primary

Addresses

Primary practice location

1119 McLaughlin St
Statesville, NC 28677-6862

Mailing address

1119 McLaughlin St
Statesville, NC 28677-6862
Phone (704) 838-0941

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
000000000NCMDCase Manager/Care Coordinator

NPI Registry JSON

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269475200000",
    "number": "1649594235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 MCLAUGHLIN ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286776862",
            "telephone_number": "704-838-0941",
            "fax_number": "704-838-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 MCLAUGHLIN ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286776862",
            "telephone_number": "704-838-0941",
            "fax_number": "704-838-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "WANDA",
        "middle_name": "S",
        "credential": "CASEMANAGER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-25",
        "last_updated": "2010-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NC",
            "license": "000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; 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.