Active NPI
John Calvin Hardin III, MD
- Specialist
- Shreveport, LA
National Provider Identifier
1700872934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 061835
- Practice address
- 1801 Fairfield Ave
#105
Shreveport, LA 71101-4443 - Phone
- (318) 424-2192
- Fax
- (318) 424-2595
- NPI assigned
- Sep 22, 2005
- Reactivated
- Apr 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 061835 | LA | Primary |
Addresses
Primary practice location
1801 Fairfield Ave
#105
Shreveport, LA 71101-4443
Mailing address
1801 Fairfield Ave
#105
Shreveport, LA 71101-4443
Phone (318) 424-2192
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1352781 | Medicaid | LA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 061835 | LA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana Cardiovascular Associates Ampc Dba Louisiana Heart Associate | Specialist | 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 and National Provider Directory roles.
-
- Specialist
- Shreveport, LA
- NPI 1275672248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339113600000",
"number": "1700872934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 FAIRFIELD AVE",
"address_2": "#105",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014443",
"telephone_number": "318-424-2192",
"fax_number": "318-484-2595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 FAIRFIELD AVE",
"address_2": "#105",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711014443",
"telephone_number": "318-424-2192",
"fax_number": "318-424-2595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDIN",
"first_name": "JOHN",
"middle_name": "CALVIN",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2012-06-08",
"deactivation_date": "2006-03-24",
"reactivation_date": "2006-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "LA",
"license": "061835",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1352781",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.