Individual provider Active NPI

Michael Wayne Hardee, M.D.

  • Family Medicine Physician
  • Mooresville, NC
National Provider Identifier
1720075955
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2000-00816 Issued in NC
Practice address
444 Williamson Road
Suite E
Mooresville, NC 28117
Phone
(704) 658-9779
Fax
(704) 658-9773
NPI assigned
Oct 3, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2000-00816 NC Primary

Addresses

Primary practice location

444 Williamson Road
Suite E
Mooresville, NC 28117

Mailing address

444 Williamson Road
Suite E
Mooresville, NC 28117
Phone (704) 658-9779

Other identifiers 4

IdentifierTypeStateIssuer
02629OtherNCBLUE CROSS BLUE SHEILD
3974316OtherNCCIGNA
891267WMedicaidNC
2281030OtherNCMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000214 NC Practitioner - Family Practice 5991765208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Duke University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hardee Family Medicine PAGroup PAC ID 6103886403, 3 clinicians

Practice addresses (Care Compare)

444 Williamson Rd E
Mooresville, NC 28117-9248
Phone (704) 658-9779

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2000-00816NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hardee Family Medicine PA Family Medicine CurrentSince Oct 1, 2000 Accepting new patients

Locations

444 Williamson Rd
Ste E
Mooresville, NC 28117
Phone (704) 658-9779

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.

Hospital & facility affiliations 3

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": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1720075955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 WILLIAMSON ROAD",
            "address_2": "SUITE E",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-658-9779",
            "fax_number": "704-658-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 WILLIAMSON ROAD",
            "address_2": "SUITE E",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-658-9779",
            "fax_number": "704-658-9773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEE",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-03",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2000-00816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "02629",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3974316",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891267W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2281030",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.