Shaquavia Rosalee Hardy, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD.MD.61616273 Issued in WA

Practice address

5150 Village Park Dr SE
Bellevue, WA 98006-6652

Phone

(425) 657-0620

Fax

(425) 502-8425

NPI assigned

Jun 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeside Center for Autism, LLC

  • Speech-Language Pathologist
  • Bellevue, WA
  • NPI 1588802953
  NPD
• Ican America

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508325929
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1659941672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 VILLAGE PARK DR SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980066652",
            "telephone_number": "425-657-0620",
            "fax_number": "425-502-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 VILLAGE PARK DR SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980066652",
            "telephone_number": "425-657-0620",
            "fax_number": "425-502-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "SHAQUAVIA",
        "middle_name": "ROSALEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD.MD.61616273",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MT224503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wesley Aaron Hardgrove, MD
• Stephanie Renee Hardwick, LMHCA
• Rhonda May Hardy-Joel, CNP, CRNA
• Krysten Hardy, MSW
• Shaiann Felicia Hardy
• Edwin Hargitt III, MD
• Jennifer Hargrove
• Sarah Lambert Harkins, M.ED, NBCT
• Anthony Harkishnani
• Erin Harley, PH.D.

• Pediatrics Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.