Active NPI
Lance E Hardwig, P.A,
- Physician Assistant
- Nett Lake, MN
National Provider Identifier
1760494611
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 30109
- Practice address
- 13071 Nett Lake Rd.
Nett Lake, MN 55771 - Phone
- (218) 757-3295
- Fax
- (218) 757-0222
- NPI assigned
- Aug 12, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 30109 | Primary |
Addresses
Primary practice location
13071 Nett Lake Rd.
Nett Lake, MN 55771
Mailing address
3920 13TH Ave E
Suite 6
Hibbing, MN 55746-3675
Phone (218) 263-7540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 63G36HA | Other | MN | BCBS |
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
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1760494611",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3920 13TH AVE E",
"address_2": "SUITE 6",
"city": "HIBBING",
"state": "MN",
"postal_code": "557463675",
"telephone_number": "218-263-7540",
"fax_number": "866-732-0699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13071 NETT LAKE RD.",
"city": "NETT LAKE",
"state": "MN",
"postal_code": "55771",
"telephone_number": "218-757-3295",
"fax_number": "218-757-0222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARDWIG",
"first_name": "LANCE",
"middle_name": "E",
"credential": "P.A,",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": "30109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "63G36HA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nett Lake, MN
- Bois Forte Reservation Tribal Council (Bois Forte Human Services)
- Bois Forte Reservation Tribal Council (Bois Forte Human Services)
- Bois Forte Reservation Tribal Government
- Bois Forte Reservation Tribal Government (Bois Forte Medical Clinic Pharmacy)
- Melissa Joan Grzybowski
- Andrew Thomas Jones, DDS
- Julie Skoglund, PHARMD
- St. Louis & Koochiching Cos Ind School Dist 707
- Shanna Rachelle Vidor, M.D.
- Joe Witt, LP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.