Individual provider Active NPI

Laura Renea Hardy

  • Family Nurse Practitioner
  • Collinsville, MS
National Provider Identifier
1669065546
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904435 Issued in MS
Practice address
9097 Collinsville Rd
Collinsville, MS 39325-9779
Phone
(601) 626-8874
NPI assigned
Feb 11, 2021
Last updated
Feb 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904435 MS Primary

Addresses

Primary practice location

9097 Collinsville Rd
Collinsville, MS 39325-9779

Mailing address

6489 King Rd
Meridian, MS 39305-8362
Phone (601) 663-5686

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722000851 MS Practitioner - Nurse Practitioner 1456754811 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush Medical FoundationGroup PAC ID 2567368541, 31 clinicians

Practice addresses (Care Compare)

2800 N Hills St
Ochsner Health Center North Meridia
Meridian, MS 39305-2643
Phone (601) 693-9906

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904435MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rush Medical Foundation CurrentSince May 1, 2023 Accepting new patients
Rush Medical Foundation Current Accepting new patients
Medical Foundation, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Medical Foundation, Inc. CurrentSince Jul 1, 2021 Accepting new patients
Rush Medical Foundation CurrentSince May 1, 2023 Accepting new patients

Locations

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

603 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-2123

605 S Archusa Ave
Quitman, MS 39355
Phone (601) 776-6925

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1669065546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6489 KING RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393058362",
            "telephone_number": "601-663-5686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9097 COLLINSVILLE RD",
            "city": "COLLINSVILLE",
            "state": "MS",
            "postal_code": "393259779",
            "telephone_number": "601-626-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDY",
        "first_name": "LAURA",
        "middle_name": "RENEA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collinsville, MS

Sources for this page

Verify at the official NPI Registry.